Assessment of simultaneous IgM, IgG avidity, and IgA testing in diagnosis of acute toxoplasmosis in pregnant women: a systematic review and meta-analysis study

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BACKGROUNDS: Toxoplasma gondii is a relatively common parasite with a global prevalence that can cause toxoplasmosis. This infection usually does not have clear symptoms, so timely and accurate detection plays a major role in the treatment of this disease. This study reviewed Toxoplasma antibodies dependent serologic tests in pregnancy, assessing their diagnostic effectiveness to guide healthcare providers, particularly obstetricians and gynecologists. METHODS: In this systematic review and meta-analysis, we utilized four different databases for our search and adhered to the PRISMA guidelines to collect pertinent studies in duration of 2000 to April 2024. After carefully evaluating the inclusion/exclusion criteria list, we ultimately selected 67 qualifying studies for our analysis and subjecting the obtained data to statistical scrutiny. RESULTS: Data analysis revealed that the pooled seroprevalence of IgM anti-T. gondii among pregnant women tested were 2.1% (95% CI = 1.67 to 3.03). Moreover, the weighted seroprevalence rate estimate of low IgG avidity in IgM-positive pregnant women was 30% (95% CI = 28 to 31) and the seroprevalence of IgA in IgM-positive pregnant women was 43% (95% CI = 18 to 70). Combining the IgG avidity test results with those of IgM and IgA can significantly improve the accuracy of diagnosing recent and past Toxoplasma infections. CONCLUSIONS: This approach is particularly valuable for pregnant women, as it improves the reliability of serological test outcomes and helps to provide timely treatment and mitigate irreversible complications associated with toxoplasmosis.

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