Seroprevalence, Risk Factors and Maternal–Fetal Outcomes of <i>Toxoplasma gondii</i> in Pregnant Women from WHO Eastern Mediterranean Region: Systematic Review and Meta-Analysis
Background: The protozoan parasite <i>Toxoplasma gondii</i> may cause serious illness in the immunocompromised. The <i>Toxoplasma gondii</i> seropositive prevalence in pregnant women in WHO Eastern Mediterranean Region countries is inconsistent in the literature and it is ass...
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2023-09-01
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| author | Ali A. Rabaan Leonard Ighodalo Uzairue Amal H. Alfaraj Muhammad A. Halwani Muzaheed Abdulsalam Alawfi Amer Alshengeti Nawal A. Al Kaabi Eman Alawad Mashael Alhajri Sara Alwarthan Abeer N. Alshukairi Souad A. Almuthree Roua A. Alsubki Nada N. Alshehri Mohammed Alissa Hawra Albayat Tasneem I. Zaidan Hassan Alagoul Ali Al Fraij Jeehan H. Alestad |
| author_facet | Ali A. Rabaan Leonard Ighodalo Uzairue Amal H. Alfaraj Muhammad A. Halwani Muzaheed Abdulsalam Alawfi Amer Alshengeti Nawal A. Al Kaabi Eman Alawad Mashael Alhajri Sara Alwarthan Abeer N. Alshukairi Souad A. Almuthree Roua A. Alsubki Nada N. Alshehri Mohammed Alissa Hawra Albayat Tasneem I. Zaidan Hassan Alagoul Ali Al Fraij Jeehan H. Alestad |
| author_sort | Ali A. Rabaan |
| collection | DOAJ |
| description | Background: The protozoan parasite <i>Toxoplasma gondii</i> may cause serious illness in the immunocompromised. The <i>Toxoplasma gondii</i> seropositive prevalence in pregnant women in WHO Eastern Mediterranean Region countries is inconsistent in the literature and it is associated with outcomes that have not be fully elucidated, hence the need for a better understanding of the pooled seroprevalence and associated maternal and fetal outcomes. Objective: The objective was to conduct a systematic literature review and determine the pooled prevalence of WHO Eastern Mediterranean Regional countries’ pregnant women’s seroprevalence of <i>Toxoplasma gondii</i> and the maternal–fetal outcomes. Methods: This quantitative study examined WHO Eastern Mediterranean countries’ maternal–fetal outcomes and <i>Toxoplasma gondii</i> prevalence in pregnant women. The targeted population was pregnant women, while the primary outcome was seropositivity of <i>Toxoplasma gondii</i>, while other outcomes such as maternal and fetal associations and risk factors were determined PubMed, SCOPUS, MEDLINE, and Index Medicus for the Eastern Mediterranean Region (IMEMR) databases were searched up until 30 January 2023. The search terms used were “<i>Toxoplasma gondii</i>” OR “<i>Toxoplasma</i> infection” AND “Pregnant woman” or pregnan* OR Antenatal OR Prenatal OR Gravidity OR Parturition OR Maternal AND WHO Eastern Mediterranean Region). OpenMeta-Analyst and Jamovi were used to analyze the generated data. Results: In total, 95 of 2947 articles meeting the inclusion criteria examined <i>Toxoplasma gondii</i> prevalence in pregnant women from WHO Eastern Mediterranean countries. The pooled prevalence of <i>Toxoplasma gondii</i> in pregnant women was 36.5% (95%CI: 32.6–40.4) with a median value of 35.64%, range values of 1.38–75.30%, with 99.61% heterogeneity. The pooled seroprevalence of IgG of <i>Toxoplasma gondii</i> was 33.5% (95%CI: 29.8–37.2) with a median value of 33.51%, and a range values of 1.38–69.92%; the pooled seroprevalence of IgM was 3.6% (95%CI: 3.1–4.1)) with a median value of 3.62 and range values of 0.20–17.47%, while cases of pooled seroprevalence of both IgG and IgM positivity was 3.0% (95%CI: 1.9–4.4) with a median value of 2.05 and a range values of 0.05–16.62%. Of the <i>Toxoplasma gondii</i> seropositive women, 1281/3389 (34.8%) 174/1765 (32.9%), 1311/3101 (43.7%), and 715/1683 (40.8%) of them had contact with cats, drank unprocessed milk, ate raw or undercooked meat and ate unwashed raw vegetables, respectively. The maternal–fetal outcomes associated with <i>Toxoplasma gondii</i> seropositivity were a history of abortions, miscarriage, stillbirth, intrauterine fetal death, and premature birth, which were found in 868/2990 (32.5%), 112/300 (36.1%), 111/375 (25.7%), 3/157 (1.9%) and 96/362 (20.1%) of women who tested positive for <i>Toxoplasma gondii</i> antibodies. Conclusion: The study found a high proportion of <i>Toxoplasma gondii</i> seroprevalence in pregnant women in the WHO Eastern Mediterranean Region, which may be linked to poor outcomes for mothers and their babies. Thus, pregnant women require monitoring and comprehensive prevention strategies for <i>Toxoplasma gondii</i> infection. |
| first_indexed | 2024-03-10T22:18:46Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2076-0817 |
| language | English |
| last_indexed | 2024-03-10T22:18:46Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pathogens |
| spelling | doaj.art-d2d97cdc6d9b4d5f9e2386417df2b5ff2023-11-19T12:22:52ZengMDPI AGPathogens2076-08172023-09-01129115710.3390/pathogens12091157Seroprevalence, Risk Factors and Maternal–Fetal Outcomes of <i>Toxoplasma gondii</i> in Pregnant Women from WHO Eastern Mediterranean Region: Systematic Review and Meta-AnalysisAli A. Rabaan0Leonard Ighodalo Uzairue1Amal H. Alfaraj2Muhammad A. Halwani3Muzaheed4Abdulsalam Alawfi5Amer Alshengeti6Nawal A. Al Kaabi7Eman Alawad8Mashael Alhajri9Sara Alwarthan10Abeer N. Alshukairi11Souad A. Almuthree12Roua A. Alsubki13Nada N. Alshehri14Mohammed Alissa15Hawra Albayat16Tasneem I. Zaidan17Hassan Alagoul18Ali Al Fraij19Jeehan H. Alestad20Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi ArabiaDepartment of Medical Laboratory Science, Federal University, Oye-Ekiti 371104, Ekiti State, NigeriaPediatric Department, Abqaiq General Hospital, First Eastern Health Cluster, Abqaiq 33261, Saudi ArabiaDepartment of Medical Microbiology, Faculty of Medicine, Al Baha University, Al Baha 47810, Saudi ArabiaDepartment of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi ArabiaDepartment of Pediatrics, College of Medicine, Taibah University, Al-Madinah 41491, Saudi ArabiaDepartment of Pediatrics, College of Medicine, Taibah University, Al-Madinah 41491, Saudi ArabiaDepartment of Pediatric Infectious Disease, Sheikh Khalifa Medical City, Abu Dhabi 51900, United Arab EmiratesAdult Infectious Diseases Department, Prince Mohammed Bin Abdulaziz Hospital, Riyadh 11474, Saudi ArabiaDepartment of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi ArabiaDepartment of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi ArabiaCollege of Medicine, Alfaisal University, Riyadh 11533, Saudi ArabiaDepartment of Infectious Disease, King Abdullah Medical City, Makkah 43442, Saudi ArabiaDepartment of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi ArabiaInternal Medicine Department, College of Medicine, King Khalid University Medical City, Abha 61481, Saudi ArabiaDepartment of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi ArabiaInfectious Disease Department, King Saud Medical City, Riyadh 7790, Saudi ArabiaPediatric Department, King Abdulaziz Hospital, Jeddah 23831, Saudi ArabiaBlood Bank Section, Dammam Regional Laboratory and Blood Bank, Dammam 31411, Saudi ArabiaMedical Laboratories & Blood Bank Department, Jubail Health Network, Eastern Health Cluster, Ministry of Health, Jubail 35514, Saudi ArabiaImmunology and Infectious Microbiology Department, University of Glasgow, Glasgow G1 1XQ, UKBackground: The protozoan parasite <i>Toxoplasma gondii</i> may cause serious illness in the immunocompromised. The <i>Toxoplasma gondii</i> seropositive prevalence in pregnant women in WHO Eastern Mediterranean Region countries is inconsistent in the literature and it is associated with outcomes that have not be fully elucidated, hence the need for a better understanding of the pooled seroprevalence and associated maternal and fetal outcomes. Objective: The objective was to conduct a systematic literature review and determine the pooled prevalence of WHO Eastern Mediterranean Regional countries’ pregnant women’s seroprevalence of <i>Toxoplasma gondii</i> and the maternal–fetal outcomes. Methods: This quantitative study examined WHO Eastern Mediterranean countries’ maternal–fetal outcomes and <i>Toxoplasma gondii</i> prevalence in pregnant women. The targeted population was pregnant women, while the primary outcome was seropositivity of <i>Toxoplasma gondii</i>, while other outcomes such as maternal and fetal associations and risk factors were determined PubMed, SCOPUS, MEDLINE, and Index Medicus for the Eastern Mediterranean Region (IMEMR) databases were searched up until 30 January 2023. The search terms used were “<i>Toxoplasma gondii</i>” OR “<i>Toxoplasma</i> infection” AND “Pregnant woman” or pregnan* OR Antenatal OR Prenatal OR Gravidity OR Parturition OR Maternal AND WHO Eastern Mediterranean Region). OpenMeta-Analyst and Jamovi were used to analyze the generated data. Results: In total, 95 of 2947 articles meeting the inclusion criteria examined <i>Toxoplasma gondii</i> prevalence in pregnant women from WHO Eastern Mediterranean countries. The pooled prevalence of <i>Toxoplasma gondii</i> in pregnant women was 36.5% (95%CI: 32.6–40.4) with a median value of 35.64%, range values of 1.38–75.30%, with 99.61% heterogeneity. The pooled seroprevalence of IgG of <i>Toxoplasma gondii</i> was 33.5% (95%CI: 29.8–37.2) with a median value of 33.51%, and a range values of 1.38–69.92%; the pooled seroprevalence of IgM was 3.6% (95%CI: 3.1–4.1)) with a median value of 3.62 and range values of 0.20–17.47%, while cases of pooled seroprevalence of both IgG and IgM positivity was 3.0% (95%CI: 1.9–4.4) with a median value of 2.05 and a range values of 0.05–16.62%. Of the <i>Toxoplasma gondii</i> seropositive women, 1281/3389 (34.8%) 174/1765 (32.9%), 1311/3101 (43.7%), and 715/1683 (40.8%) of them had contact with cats, drank unprocessed milk, ate raw or undercooked meat and ate unwashed raw vegetables, respectively. The maternal–fetal outcomes associated with <i>Toxoplasma gondii</i> seropositivity were a history of abortions, miscarriage, stillbirth, intrauterine fetal death, and premature birth, which were found in 868/2990 (32.5%), 112/300 (36.1%), 111/375 (25.7%), 3/157 (1.9%) and 96/362 (20.1%) of women who tested positive for <i>Toxoplasma gondii</i> antibodies. Conclusion: The study found a high proportion of <i>Toxoplasma gondii</i> seroprevalence in pregnant women in the WHO Eastern Mediterranean Region, which may be linked to poor outcomes for mothers and their babies. Thus, pregnant women require monitoring and comprehensive prevention strategies for <i>Toxoplasma gondii</i> infection.https://www.mdpi.com/2076-0817/12/9/1157<i>Toxoplasma gondii</i>pregnancyEastern Mediterraneanstillbirthmiscarriage |
| spellingShingle | Ali A. Rabaan Leonard Ighodalo Uzairue Amal H. Alfaraj Muhammad A. Halwani Muzaheed Abdulsalam Alawfi Amer Alshengeti Nawal A. Al Kaabi Eman Alawad Mashael Alhajri Sara Alwarthan Abeer N. Alshukairi Souad A. Almuthree Roua A. Alsubki Nada N. Alshehri Mohammed Alissa Hawra Albayat Tasneem I. Zaidan Hassan Alagoul Ali Al Fraij Jeehan H. Alestad Seroprevalence, Risk Factors and Maternal–Fetal Outcomes of <i>Toxoplasma gondii</i> in Pregnant Women from WHO Eastern Mediterranean Region: Systematic Review and Meta-Analysis Pathogens <i>Toxoplasma gondii</i> pregnancy Eastern Mediterranean stillbirth miscarriage |
| title | Seroprevalence, Risk Factors and Maternal–Fetal Outcomes of <i>Toxoplasma gondii</i> in Pregnant Women from WHO Eastern Mediterranean Region: Systematic Review and Meta-Analysis |
| title_full | Seroprevalence, Risk Factors and Maternal–Fetal Outcomes of <i>Toxoplasma gondii</i> in Pregnant Women from WHO Eastern Mediterranean Region: Systematic Review and Meta-Analysis |
| title_fullStr | Seroprevalence, Risk Factors and Maternal–Fetal Outcomes of <i>Toxoplasma gondii</i> in Pregnant Women from WHO Eastern Mediterranean Region: Systematic Review and Meta-Analysis |
| title_full_unstemmed | Seroprevalence, Risk Factors and Maternal–Fetal Outcomes of <i>Toxoplasma gondii</i> in Pregnant Women from WHO Eastern Mediterranean Region: Systematic Review and Meta-Analysis |
| title_short | Seroprevalence, Risk Factors and Maternal–Fetal Outcomes of <i>Toxoplasma gondii</i> in Pregnant Women from WHO Eastern Mediterranean Region: Systematic Review and Meta-Analysis |
| title_sort | seroprevalence risk factors and maternal fetal outcomes of i toxoplasma gondii i in pregnant women from who eastern mediterranean region systematic review and meta analysis |
| topic | <i>Toxoplasma gondii</i> pregnancy Eastern Mediterranean stillbirth miscarriage |
| url | https://www.mdpi.com/2076-0817/12/9/1157 |
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