Prevalência de toxoplasmose em gestantes de acordo com a raça ou etnia: uma revisão sistemática

Abstract

Introduction: Toxoplasmosis is an infectious disease caused by the protozoan Toxoplasma gondii, which can affect both humans and animals. Although most infected individuals remain asymptomatic, infection in pregnant women can result in serious complications for the mother-fetus binomial. In this context, it is essential to deepen knowledge about the prevalence of toxoplasmosis, especially in vulnerable populations, to support strategies for prevention and control of the disease. Objective: to identify the prevalence of toxoplasmosis during pregnancy according to race or ethnicity through a systematic review of the literature. Methodology: the protocol for this review is registered on the PROSPERO platform under number CRD42024596261. The searches were conducted in the PUBMED, LILACS, Web of Science, Scopus and CINAHL databases, in addition to the gray literature (Google Scholar and BNTD), using the terms “Toxoplasmosis”, “Toxoplasma infection”, “Toxoplasma gondii”, “Pregnant women”, “Pregnancy” and “Prenatal Care” combined with Boolean operators. For eligibility, cross-sectional studies that presented the prevalence of toxoplasmosis in pregnant women together with the race/ethnicity variable were included. The assessment of the quality of the studies and the risk of bias follows the Joanna Briggs Critical Appraisal Checklist for Analytical Cross-Sectional Studies instrument. The writing is based on the PRISMA (Preferred Reporting Items for Systematic Reviews and MetaAnalysis) guidelines. Results: Twelve articles were included to compose this review. The extracted data were tabulated and analyzed qualitatively. The studies analyzed identified differences in the prevalence of toxoplasmosis between ethnic-racial groups. In Brazil, brown (74.54%) and indigenous (83.33%) people had the highest prevalence in Ilhéus, while brown people in Foz do Iguaçu reached 34%. In the United Kingdom, Afro-Caribbean people recorded 31.48%, and in Sri Lanka, Sinhalese people had a higher prevalence (13.56%) compared to non-Sinhalese people (6.3%), highlighting variations between continents. Final considerations: The results reveal significant differences in the prevalence of toxoplasmosis among ethnic-racial groups, highlighting greater vulnerability in brown, indigenous and black populations in several regions. Socioeconomic, cultural and environmental factors contribute to these inequalities, aggravated by unequal access to health services.