Abstract：
Humans are infected by Toxoplasma gondii worldwide and its consequences may seriously affect an immune deprived population such as HIV and transplanted patients or pregnant women and foetuses. A deep knowledge of toxoplasmosis seroprevalence in Spain is needed in order to better shape health policies and educational programs. We present the results of the first systematic review and meta-analysis on the human prevalence for this disease in Spain. Databases (PubMed, Web of Science, SCOPUS and Teseo) were searched for relevant studies that were published between January 1993 and December 2023 and all population-based cross-sectional and longitudinal studies reporting the human seroprevalence in Spain were revised. Within the population analysed, our targeted groups were immunocompetent population, pregnant women and immunocompromised patients. Among 572 studies and 35 doctoral theses retrieved, 15 studies and three doctoral theses were included in the meta-analysis. A random effects model was used for the meta-analyses due to the high heterogeneity found between studies (I2: 99.97), since it is a statistically conservative model, in addition to allowing better external validity. The global pooled seroprevalence was 32.3% (95% CI 28.7-36.2%). Most of the studies carried out were in pregnant women and the meta-analysis reported that the pooled seroprevalence of toxoplasmosis in pregnant women in Spain was 24.4% (24,737/85,703, 95% CI 21.2-28.0%), based on the random effects model. It is recommended to continue monitoring the seroprevalence status of T. gondii in order to obtain essential guidelines for the prevention and control of the infection in the population.
摘要：
人类在世界范围内感染弓形虫，其后果可能会严重影响缺乏免疫力的人群，例如艾滋病毒和移植患者或孕妇和胎儿。为了更好地制定卫生政策和教育计划，需要对西班牙弓形虫病血清阳性率有深入的了解。我们介绍了有关西班牙这种疾病的人类患病率的首次系统评价和荟萃分析的结果。数据库(PubMed,WebofScience,SCOPUS和Teseo）搜索了1993年1月至2023年12月之间发表的相关研究，并修订了所有报告西班牙人类血清阳性率的基于人群的横截面和纵向研究。在分析的人口中，我们的目标群体是有免疫能力的人群，孕妇和免疫功能低下的患者。在检索到的572项研究和35篇博士论文中，15项研究和3篇博士论文被纳入荟萃分析。随机效应模型用于荟萃分析，因为研究之间存在高度异质性(I2：99.97)，因为这是一个统计上保守的模型，除了允许更好的外部有效性。整体合并血清阳性率为32.3％（95％CI28.7-36.2％）。大多数研究是在孕妇中进行的，荟萃分析报告说，西班牙孕妇弓形虫病的合并血清阳性率为24.4％（24,737/85,703，95％CI21.2-28.0％），基于随机效应模型。建议继续监测弓形虫的血清阳性率状况，以获得预防和控制人群感染的基本指南。
