Toxoplasmosis among Pregnant Women in Africa: A Systematic Review and Meta-Analysis

Toxoplasmosis in pregnancy may have serious consequences on the pregnancy outcome. Vertical transmission to the fetus may range from obstetrics complications such as abortion, intrauterine growth restriction, stillbirth to congenital malformations. This review aimed to assess the seroprevalence rate of toxoplasmosis in pregnant women in Africa so that a proper management policy can be initiated. Four databases that include Google Scholar, ScienceDirect, Scopus, and PubMed were searched for primary studies reported on the prevalence of toxoplasmosis among pregnant women in African countries. From the search, total of 39 studies were included for the study from 1980 to 2018. Total of 11986 pregnant women were the study participants in the included studies. By using the DerSimonian-Liard random effects method, the pooled prevalence of toxoplasmosis was estimated as 47% (95%CI=38.4% to55.4%). Publication bias was assessed using Egger's test, 2.88 (95%CI= -8.8% to 14.5%) and it did not indicate any significant (P = 0.619) influence of the studies on the pool estimate. Again, the pooled estimates of toxoplasmosis among pregnant women in first, second and third trimesters were 29% (95% CI= 17.0% to 42.0%), 35.0% (95%CI= 27% - 43%) and 30.9% (95%CI= 22% - 41%), respectively. Pooled prevalence for risk factors such as 'contacts with cat', cat ownership and consumption of raw or poorly cooked meat were estimated at 50% (95% CI= 35% to 66%), 26.2% (95% CI=17.9% to 35.5%) and 43.3% (95% CI = 30% to 50%) respectively. This study estimates the overall prevalence of toxoplasmosis in pregnancy and some possible risk factors through which majority of pregnant women can be infected. Proper screening against this infection should be instituted in full capacity to curb the endemicity and consequences of the infection on the fetus.