Anti-Toxoplasma gondii IgG seroprevalence in the general population in Iran: A systematic review and meta-analysis, 2000-2023.

Abstract

Toxoplasmosis ranks among the most prevalent parasitic diseases globally. It seems that chronic toxoplasmosis is associated with several neuropsychiatric and other harmful effects in infected people, therefore, there is a need to investigate the prevalence of toxoplasmosis across various world regions. In this study, we conducted a meticulous meta-analysis to estimate the seroprevalence of anti-Toxoplasma gondii IgG antibodies within the general population in Iran (GPI). International and national scientific databases for studies published between January 1, 2000, and September 30, 2023, were searched. Observational studies reporting anti-T. gondii IgG seroprevalence in the GPI was selected/included. The data were synthesized using a random-effects model to calculate with a 95% confidence interval (95% CI) the national and regional anti-T. gondii IgG seroprevalence rates in Iran. Additionally, subgroup analyses were conducted to investigate the frequency of exposition to T. gondii in different socio-demographic, climatic, and geographical scenarios. From 18661 identified studies, 327 were included in the present meta-analysis, encompassing 122,882 individuals across the 31 Iranian provinces. The pooled nationwide anti-T. gondii IgG seroprevalence among the GPI was determined to be 32.9% (95% CI: 30.9-35.1%). The highest anti-T. gondii IgG seroprevalence was observed in Mazandaran province (North of Iran) (61%), whereas the lowest was in Semnan province (12.5%).Anti-T. gondii IgG seroprevalence demonstrated a higher occurrence in provinces characterized by moderate temperatures of 16-21°C, high relative humidity, and annual precipitation. Additionally, a higher anti-T. gondii IgG seroprevalence was identified among individuals with a habit of consumption of undercooked meat, raw fruits or vegetables, and untreated water. Moreover, those reporting direct contact with cats, possessing a lower level of education, residing in rural areas, being engaged in farming occupations, or playing the role of housewives exhibited higher anti-T. gondii IgG seroprevalence figures.The anti-T. gondii IgG seroprevalence within GPI closely aligns with the estimated worldwide average exposition rates. This underscores the imperative for public health policymakers to prioritize educational efforts regarding toxoplasmosis transmission pathways and its link to harmful effects.