%0 Journal Article
%T Global prevalence of latent toxoplasmosis in pregnant women: a systematic review and meta-analysis.
%A Rostami A
%A Riahi SM
%A Gamble HR
%A Fakhri Y
%A Nourollahpour Shiadeh M
%A Danesh M
%A Behniafar H
%A Paktinat S
%A Foroutan M
%A Mokdad AH
%A Hotez PJ
%A Gasser RB
%J Clin Microbiol Infect
%V 26
%N 6
%D Jun 2020
%M 31972316
%F 13.31
%R 10.1016/j.cmi.2020.01.008
%X <B>BACKGROUND: </B>Toxoplasma gondii infection, if acquired as an acute infection during pregnancy, can have substantial adverse effects on mothers, fetuses and newborns. Latent toxoplasmosis also causes a variety of pathologies and has been linked to adverse effects on pregnancy.<BR><B>OBJECTIVE: </B>Here, we present results of a comprehensive systematic review and meta-analysis of the global prevalence of latent toxoplasmosis in pregnant women.<BR><B>METHODS: </B>We searched PubMed, EMBASE, Web of Science, SciELO and Scopus databases for relevant studies that were published between 1 January 1988 and 20 July 2019.<BR><B>METHODS: </B>All population-based, cross-sectional and longitudinal studies reporting the prevalence of latent toxoplasmosis in healthy pregnant women were considered for inclusion.<BR><B>METHODS: </B>Pregnant women who were tested for prevalence of latent toxoplasmosis.<BR><B>METHODS: </B>There were no interventions.<BR><B>METHODS: </B>We used a random effects model to calculate pooled prevalence estimates with 95% confidence intervals (CIs). We grouped prevalence data according to the geographic regions defined by the World Health Organization (WHO). Multiple subgroup and meta-regression analyses were performed.<BR><B>RESULTS: </B>In total, 311 studies with 320 relevant data sets representing 1 148 677 pregnant women from 91 countries were eligible for inclusion in the meta-analysis. The global prevalence of latent toxoplasmosis in pregnant women was estimated at 33.8% (95% CI, 31.8-35.9%; 345 870/1 148 677). South America had the highest pooled prevalence (56.2%; 50.5-62.8%) of latent toxoplasmosis in pregnant women, whereas the Western Pacific region had the lowest prevalence (11.8%; 8.1-16.0%). A significantly higher prevalence of latent toxoplasmosis was associated with countries with low income and low human development indices (p < 0.001).<BR><B>CONCLUSIONS: </B>Our results indicate a high level of latent toxoplasmosis in pregnant women, especially in some low- and middle-income countries of Africa and South America, although the local prevalence varied markedly. These results suggest a need for improved prevention and control efforts to reduce the health risks to women and newborns.