Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, PO Box 1274, Yaoundé, Cameroon.
Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
Sci Rep. 2020 Jul 21;10(1):12102. doi: 10.1038/s41598-020-69078-9.
Efficient health-care for pregnant women require accurate data on the prevalence of toxoplasmosis in pregnancy at global, regional, and country levels. In this systematic review with meta- and modelling-analysis, we searched PubMed, EMBASE, Web of Knowledge, Global Index Medicus, and Africa Journal Online to identify studies that reported enough data to compute the immunoglobulins (Ig) M or G seroprevalence estimates of Toxoplasma gondii in pregnant women up to December 31st, 2018, without any language restriction. The global and regional estimates were done using a random-effects meta-analysis. We included 250 studies with 723,655 pregnant women. The global IgM seroprevalence was 1.9% (95%CI: 1.7-2.3). At the regional level, Eastern Mediterranean had the highest IgM seroprevalence (4.1%, 95%CI: 2.8-5.5) and The Americas, the lowest (1.1%, 0.8-1.4), with a statistically significant difference between WHO regions (p < 0.0001). The global IgG seroprevalence was 32.9% (95%CI: 29.4-36.4). Among WHO regions, The Americas had the highest prevalence (45.2%, 95%CI: 33.4-53.4) and Western Pacific the lowest (11.2%, 7.8-15.1), with a statistically significant difference between regions (p < 0.0001). This study presents a high toxoplasma seropositivity in pregnant women at global, regional and country levels, with a consequential high risk of maternal and congenital toxoplasmosis.
为了实现孕妇医疗保健的高效性，我们需要掌握全球、地区和国家层面妊娠期弓形虫病流行率的准确数据。在这项系统综述中，我们通过荟萃分析和模型分析，检索了 PubMed、EMBASE、Web of Knowledge、全球医学索引和非洲在线期刊，以确定截至 2018 年 12 月 31 日，发表的报道了足够数据以计算孕妇弓形虫免疫球蛋白（Ig）M 或 G 血清阳性率估计值的研究，且这些研究没有任何语言限制。我们采用随机效应荟萃分析来计算全球和地区估计值。我们共纳入了 250 项研究，共涉及 723655 名孕妇。全球 IgM 血清阳性率为 1.9%（95%CI：1.7-2.3）。在地区层面，东地中海地区的 IgM 血清阳性率最高（4.1%，95%CI：2.8-5.5），美洲地区最低（1.1%，0.8-1.4），不同世卫组织地区之间存在统计学显著差异（p<0.0001）。全球 IgG 血清阳性率为 32.9%（95%CI：29.4-36.4）。在世卫组织地区中，美洲地区的 IgG 血清阳性率最高（45.2%，95%CI：33.4-53.4），西太平洋地区最低（11.2%，7.8-15.1），不同地区之间存在统计学显著差异（p<0.0001）。本研究表明，全球、地区和国家层面孕妇的弓形虫血清阳性率较高，母体和先天性弓形虫病的风险较大。
