Seroprevalence of Toxoplasma gondii and its associated risk factors among women of reproductive age in Saudi Arabia: a systematic review and meta-analysis

Toxoplasma gondii (T. gondii), which infects many warm-blooded animals including humans, causes toxoplasmosis, a globally widespread condition. To date, no research has explored the overall T. gondii infection seroprevalence among women in Saudi Arabia, nor have the risk factors associated with the infection been examined in the Saudi Arabian context. The present systematic review and meta-analysis therefore aimed to investigate toxoplasmosis seroprevalence based on previous study samples of Saudi women of reproductive age, and to establish the potentially risk factors in this national context. PubMed, Science Direct, and Scopus were searched for studies on T. gondii seroprevalence among women in mainland Saudi Arabia published between January 2000 and December 2017. Seroprevalence with 95% CI was presented for each study, and point estimates and their 95% CIs of pooled seroprevalence were then calculated. Twenty papers were eligible for inclusion, with samples totaling 13,597 females of childbearing age (ie, between 15 and 49 years) covering various regions of Saudi Arabia. The pooled estimation for T. gondii prevalence using a random-effect model was calculated as 27.8% (95% CI =20.6%–36.3%). A significant association was observed between age and T. gondii seroprevalence. This review represents the first comprehensive and systematic evaluation of T. gondii infection seroprevalence among Saudi Arabian women, and reports a high prevalence of Toxoplasma infection. Further research is required to support the development of more cost-effective preventive strategies.