Seropositivity of toxoplasmosis in pregnant women living with HIV/AIDS worldwide: A systematic review and meta-analysis

Background: Toxoplasmosis is caused by the protozoan parasite Toxoplasma gondii, a food- and water-borne zoonotic protozoan parasite that is able to infect almost all warm-blooded vertebrates. It has a major effect on public health, particularly in underdeveloped nations. Immune-competent individuals typically exhibit no symptoms or experience a mild influenza-like sickness, while there is a possibility of severe manifestation and fatal or high-risk for life-threatening diseases in immunocompromised people like pregnant women and HIV/AIDS patients and lead to severe pathological effects on the fetus.

Method: We conducted a systematic search of databases (PubMed, Google Scholar, Science Direct, EMBASE, and Scopus) using the PRISMA criteria. We used specific keywords such as Toxoplasma gondii, Toxoplasmosis, pregnant women, prevalence, HIV/AIDS, and worldwide studies published from 2018 to 2022. We use Stata (version 14) software to estimate the pooled prevalence and heterogeneity of toxoplasmosis in pregnant women and HIV-infected people using a random-effects model and the Cochran’s Q-test, respectively. The Joanna Briggs Institute Critical Appraisal Instrument and Egger’s regression asymmetry test were used to assess study quality and publication bias, respectively, while the single study omission analysis was used to test the robustness of a pooled estimate.

Results: We included and analyzed a total of 12,887 individuals in this review. The pooled prevalence of T. gondii in this review was 40% (95% CI = 0.31–0.50). The sub-group analysis revealed that the evaluation included 11,967 pregnant women. In pregnant women, the pooled sero-prevalence was 40% (95% CI = 0.31–0.50). In pregnant women and HIV/AIDS patients, 920 individuals were evaluated, and the pooled sero-prevalence was 41% (95% CI = 0.20–0.61).

Conclusion: This review identified an overall sero-prevalence of Toxoplasma infection of 40% among pregnant women and HIV/AIDS. The expansion of prevention and control strategies, with a primary focus on enhancing educational initiatives, is necessary to avoid reactivation and stop the spread of infection, so investigative sero-prevalence is important work among pregnant women and HIV patients. In order to achieve a comprehensive explanation of the disease condition and reach this goal, we conducted a systematic review and meta-analysis in Worldwide for future use.

• Epidemiology and Determinants of Health
  • Epidemiology
• Population(s)
  • Women
  • General HIV+ population
• Co-infections
  • Other