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Incidence and prevalence of Toxoplasma gondii infection in women in France, 1980-2020: model-based estimation.
[congenital toxoplasmosis]
Toxoplasmosis
is
a
worldwide
zoonosis
due
to
Toxoplasma
gondii
,
a
ubiquitous
protozoan
parasite
of
warm-blooded
animals
including
humans
.
In
pregnant
women
,
primary
infection
can
cause
congenital
toxoplasmosis
resulting
in
severe
malformations
in
the
newborn
.
Since
1978
,
public
health
authorities
in
France
have
implemented
a
congenital
toxoplasmosis
prevention
programme
,
including
monthly
serological
screening
of
all
seronegative
pregnant
women
,
and
treatment
in
case
of
seroconversion
.
However
,
this
programme
does
not
produce
systematic
surveillance
data
on
incidence
and
prevalence
.
Our
objective
was
to
estimate
the
incidence
and
prevalence
of
T
.
gondii
infection
,
and
the
incidence
of
seroconversion
during
pregnancy
in
women
in
France
.
We
used
a
catalytic
model
to
estimate
incidence
and
prevalence
of
Toxoplasma
infection
between
1980
and
2020
in
women
of
childbearing
age
.
We
used
age-
and
time-
specific
seroprevalence
data
obtained
from
the
National
Perinatal
Surveys
(
NPS
)
conducted
in
1995
,
2003
and
2010
.
We
assumed
that
incidence
depends
both
on
age
and
calendar
time
,
and
can
be
expressed
as
the
product
of
two
unknown
functions
.
We
also
estimated
incidence
of
seroconversion
during
pregnancy
in
2010
from
the
NPS
and
the
National
Surveillance
of
Congenital
Toxoplasmosis
(
ToxoSurv
)
.
We
combined
data
of
42208
women
aged
15
-
45
years
with
serology
available
from
the
three
NPS
.
For
women
aged
30
years
the
modelled
incidence
decreased
from
7
·
5
/
1000
susceptible
women
in
1980
to
3
·
5
/
1000
in
2000
.
In
2010
the
incidence
was
2
·
4
/
1000
.
The
predicted
incidence
and
prevalence
for
2020
was
1
·
6
/
1000
and
27
%
,
respectively
.
The
incidence
of
seroconversion
during
pregnancy
in
2010
was
estimated
at
2
·
1
/
1000
susceptible
pregnant
women
(
95
%
CI
1
·
3
-
3
·
1
)
from
the
NPS
and
1
·
9
(
95
%
CI
1
·
8
-
2
·
1
)
from
ToxoSurv
.
Incidence
and
prevalence
of
Toxoplasma
infection
has
decreased
markedly
during
the
last
30
years
.
This
decrease
may
be
explained
by
a
lower
exposure
to
the
parasite
by
changes
in
food
habits
and
by
improved
hygiene
practices
in
meat
production
.
Modelled
estimations
were
consistent
with
estimates
observed
in
other
studies
conducted
previously
in
France
.
The
catalytic
modelling
provides
reliable
estimates
of
incidence
and
prevalence
of
Toxoplasma
infection
over
time
.
This
approach
might
be
useful
for
evaluating
preventive
programme
for
toxoplasmosis
.
Diseases
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Diseases presenting
"systematic surveillance data on incidence"
symptom
congenital toxoplasmosis
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