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From each source we extracted the following when available: incidence of CT, positivity to Toxoplasma-specific IgM in infants and in pregnant women, rate of seroconversion in pregnant women, and prevalence of CT in the general population, with and without age stratification study period study subjects and sampling method (where and how the subjects were selected). We used an algorithm to select the best available evidence for each country ( Fig. 1). Finally, during the preparation of the article, searches were repeated for countries with missing data for 2011–2012. The search was also widened in such cases by removing references to women of child-bearing age from the search terms. If no data were available for a country, the search was repeated to include publications as early as 1980. Publications relating only to animal studies were excluded. Initially only publication dates between 1 January 2000 and 31 December 2010 with available abstract were used. These search terms were also used in Russian, Spanish and Chinese in appropriate databases. We employed the following search terms/keywords: (toxoplasmosis or toxoplasma or TORCH) AND (immunity OR susceptibility OR seroprevalence OR sero-prevalence OR seroepidemiology OR sero-epidemiology OR serology OR seroprofile OR antibod* OR incidence) AND (pregnan* OR reproductive age OR mother* OR childbearing OR women OR antenatal). We used various models to estimate country-specific CT incidences from the data we obtained.Įastview (Russian, eastern European and other Eurasian Countries):
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We also searched for country-specific data on seropositivity to Toxoplasma-specific IgM and IgG among women of reproductive age and in the general population, with and without age stratification. In our systematic review we searched specifically for data on CT incidence in infants (seropositivity to Toxoplasma-specific IgM or confirmed case series) or on the rate of maternal transmission, from which to estimate the incidence of CT. 3 We aimed to estimate the global incidence and burden of CT as part of a larger study on the global burden of foodborne toxoplasmosis arising from an initiative coordinated by the Food Borne Disease Burden Epidemiology Reference Group of the World Health Organization (WHO). It can result in fetal death and abortion and in syndromes that include neurologic and neurocognitive deficits and chorioretinitis. 2Ĭongenital toxoplasmosis (CT) occurs in infants following maternal transmission. Alternatively, it can result from direct contact with cats or from the consumption of water or food contaminated by oocysts excreted in the faeces of infected cats. Human infection can result from the ingestion or handling of undercooked or raw meat containing tissue cysts. 1 The causative agent, Toxoplasma gondii, has a complex life cycle and is an important foodborne pathogen. Toxoplasmosis is present in every country and seropositivity rates range from less than 10% to over 90%.