Seroprevalence of Toxoplasma gondii in the Iranian pregnant women: A systematic review and meta-analysis

Toxoplasmosis is a common and serious parasitic disease with high prevalence and global distributionin human and other warm-blooded vertebrates. Though the infection of Toxoplasma gondii is usuallyasymptomatic in healthy people, it can lead to severe pathological effects to the fetus of infected womenand immunocompromised patients. So pinpointing the risk factors and control procedures are of impor-tant works among these populations. In order to reach this goal, we conducted a systematic review andmeta-analysis to identify the seroprevalence rate of T. gondii infection among Iranian pregnant womenpopulation to achieve a comprehensive explanation of the disease condition in Iran for future use. Englishelectronic databases (PubMed, Science Direct, Scopus, Ovid and Cochrane) and Persian language databases(Scientific Information Database, Iran Medex, Magiran and Iran Doc) were searched. Furthermore, the pro-ceedings of Iranian parasitology congresses were explored manually. Our review resulted in a total of 50publications meeting the inclusion criteria during Jan 1990–June 2015. Totally, 20221 women had beentested during this period of which 7724 women had seropositivity for IgG. According to results of hetero-geneity test, either Der Simonian and Laird’s random-effects method or Mantel-Haenszel’s fixed-effectsmethod were used to pool the estimations. Weighted overall prevalence of toxoplasmosis in pregnantwomen were obtained using random-effects model, which was estimated 41% (95% CI = 36–45%). AlsoIgG and IgM antibodies was obtained 38% (95% CI = 34–42%) and 4% (95% CI = 3–5%), respectively. Thehighest and the lowest seroprevalence of toxoplasmosis in five geographical zones of Iran were observedin South 53% (95% CI = 30–77%) and East 33% (95% CI = 23–42%), respectively. In order to detect publicationbias, Egger’s regression test was done which revealed that publication bias might not have a significantinfluence on overall prevalence estimate (P = 0.89). Multivariate analysis showed that there’s a statisti-cally significant correlation between toxoplasmosis and two risk factors including “place of residence”(P = 0.005) and “contact with cat” (P = 0.002). There was no significant difference between toxoplasmosisand the other surveyed risk factors. It is highly recommended to further study for the aim of better diseasemanagement and developing more efficient diagnostic tests