Gestational toxoplasmosis serological transition in territories marked by environmental vulnerability
DOI:
https://doi.org/10.36517/2175-6783.20262796309Keywords:
Toxoplasmosis, Congenital; Seroepidemiologic Studies; Disease Susceptibility; Prenatal Care; Public Health Surveillance.Abstract
Objective: to describe the temporal trend and spatial distribution of gestational toxoplasmosis in territories marked by socioenvironmental vulnerability. Methods: an observational study with a time-spatial approach based on laboratory records of pregnant women subjected to serological tests to detect infection by Toxoplasma gondii. The analyses included relative frequencies, trend assessments and spatial clustering to identify territorial susceptibility patterns. Results: predominance of acquired immunity and a high proportion of susceptible pregnant women were verified. A discrete inversion in the serological profile was observed from 2020 onwards, suggesting a reduction in environmental exposure to the parasite. Susceptibility proved to be higher among adolescents and young women. The spatial analysis evidenced three territorial patterns: High, Intermediate and Low susceptibility, with better immunity in the North area and more vulnerability in the Midsouth part of the state. Conclusion: the findings indicate a gestational toxoplasmosis serological transition, with a relative increase in the number of susceptible pregnant women in specific areas of the territory, reinforcing the importance of early screening, of retesting susceptible subjects and of regionalizing surveillance actions. Contributions to practice: the study supports improving the surveillance for gestational toxoplasmosis, guiding territorialized interventions during the pre-natal period, prioritizing vulnerable areas and strengthening public policies.
Downloads
References
1. Smith NC, Goulart C, Hayward JA, Kupz A, Miller CM, van Dooren GG. Control of human toxoplasmosis. Int J Parasitol. 2021;51(2-3):95-121. doi: https://doi.org/10.1016/j.ijpara.2020.11.001
2. Dubey JP, Murata FHA, Cerqueira-Cézar CK, Kwok OCH, Villena I. Congenital toxoplasmosis in humans: an update of worldwide rate of congenital infections. Parasitology. 2021;148(12):1406-16. doi: https://doi.org/10.1017/S0031182021001013
3. Hurt K, Kodym P, Stejskal D, Zikan M, Mojhova M, Rakovic J. Toxoplasmosis impact on prematurity and low birth weight. PLoS One. 2022; 17(1):e0262593. doi: http://dx.doi.org/10.1371/journal.pone.0262593
4. Deganich M, Boudreaux C, Benmerzouga I. Toxoplasmosis infection during pregnancy. Trop Med Infect Dis. 2022;8(1):3. doi: https://dx.doi.org/10.3390/tropicalmed8010003
5. Pereira MFL, Meneguessi GM, Brito FL, Carvalho MH, Abud RB, Mossri RMS, et al. Epidemiological profile of gestational and congenital toxoplasmosis in the Federal District, Brazil, 2019 to 2023. Arch Health Sci. 2025;31(1):e310125230. doi: https://doi.org/10.17696/2318-3691.31.01.2025.230
6. Medeiros JF, Silva ACR, Rocha NDFD, Georg AV, Melli PPDS, Quintana SM, et al. Seroprevalence of toxoplasmosis in puerperal women treated at a tertiary referral hospital. Rev Bras Ginecol Obstet. 2023;45(2):59-64. doi: https://doi.org/10.1055/s-0043-1764495
7. Silva DL, Peres MM, Barbosa MGR, Moreira NM. Diagnóstico da infecção pelo Toxoplasma gondii em gestantes de fronteira brasileira, Foz do Iguaçu. Cad Saúde Colet. 2023;31(4):e31040108. doi: http://doi.org/10.1590/1414-462X202331040108
8. Milne GC, Webster JP, Walker M. Is the incidence of congenital toxoplasmosis declining? Trends Parasitol. 2023;39(1):26-37. doi: https://dx.doi.org/10.1016/j.pt.2022.10.003
9. Carvalho QS, Carvalho NQC, Fontinele AS, Araújo ABA, Batista FMAB. Epidemiology of toxoplasmosis in pregnancy and postpartum. Rev Enferm Atual In Derme. 2025;99(Suppl 1):e025076. doi: http://doi.org/10.31011/reaid-2025-v.99-n.supl.1-art.2463
10. Fundação Amazônia de Amparo a Estudos e Pesquisas (FAPESPA). Taxa de Cobertura Populacional da Atenção Básica — 2021–2023 [Internet]. 2023 [cited Nov 25, 2025]. Available from: https://www.fapespa.pa.gov.br/sistemas/pcn2023/planilhas/4-saude/22-taxa-de-cobertura-populacional-da-aten%C3%A7ao-basica-2021-2023.xlsx
11. Morais RAPB, Carmo EL, Bichara CNC, Santos BR, Silveira KWS, Póvoa MM. Seroprevalence and risk factors associated with T. gondii infection in pregnant individuals from a Brazilian Amazon municipality. Parasite Epidemiol Control. 2020;9:e00133. doi: https://doi.org/10.1016/j.parepi.2020.e00133
12. Melo MS, Freitas LRS, Lima-Júnior FEF, Vargas A, Pereira JDS, Brito-Júnior PA, et al. Spatial pattern of congenital toxoplasmosis incidence and its relationship with vulnerability and national health indicators in Brazil. Spat Spatiotemporal Epidemiol. 2024;51:100693. doi: https://dx.doi.org/10.1016/j.sste.2024.100693
13. Lima MLF, Sousa AMAFLS, Marques LL, Ferreira IB, Giuffrida R, Kmetiuk LB, et al. Household location (urban, peri-urban and rural settlements) as an associated risk factor for toxoplasmosis during pregnancy in Southeastern Brazil. Trop Med Infect Dis. 2024;9(8):173. doi: https://doi.org/10.3390/tropicalmed9080173
14. Mascena ABS, Sousa Júnior JR, Barbosa VSA. Perfil sorológico e fatores associados à toxoplasmose em gestantes atendidas no laboratório público de Currais Novos-RN. Rev Saúde Ciênc Online. 2021;10(3):46-59. doi: http://doi.org/10.35572/rsc.v10i3.508
15. Melo MS, Cabrera LAA, Lima SVMA, Santos AD, Oliveira LMGB, Oliveira RC, et al. Temporal trend, spatial analysis and spatiotemporal clusters of infant mortality associated with congenital toxoplasmosis in Brazil: Time series from 2000 to 2020. Trop Med Int Health. 2023;28(6):476-85. doi: https://doi.org/10.1111/tmi.13877
16. Jeraldo VLS, Reis NROG. Análise espaço-temporal da toxoplasmose em gestantes do estado de Sergipe, Brasil. Interfaces Cient Saúde Ambiente. 2022;8(3):539-51. doi: https://dx.doi.org/10.17564/2316-3798.2021v8n3p539-551
17. Inagaki ADM, Souza IES, Araujo ACL, Abud ACF, Cardoso NP, Ribeiro CJN. Knowledge of toxoplasmosis among doctors and nurses who provide prenatal care. Cogitare Enferm. 2021;26:e70416. doi: https://doi.org/10.5380/ce.v26i0.70416
18. Oliveira GKA, Ferreira SRR, Moura VOL, Siqueira VDS, Reis TSA, Bridi V, et al. Biological screening for congenital toxoplasmosis in newborns from Jataí, Goiás, Brazil: a cross-sectional study. Rev Esc Enferm USP. 2024;58:e20230408. doi: http://doi.org/10.1590/1980-220x-reeusp-2023-0408en
19. Federação Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO). Toxoplasmose e gravidez [Internet]. 2021 [cited Nov. 24, 2025]. Available from: https://www.febrasgo.org.br/images/pec/anticoncepcao/n23---O---Toxoplasmose-e-gravidez.pdf
20. Chisini LA, Castilhos ED, Costa FDS, D’Avila OP. Impact of the COVID-19 pandemic on prenatal, diabetes and medical appointments in the Brazilian National Health System. Rev Bras Epidemiol. 2021;24:e210013. doi: https://dx.doi.org/10.1590/1980-549720210013
21. Almeida RAAS, Carvalho RHSBF, Lamy ZC, Alves MTSSB, Poty NARC, Thomaz EBAF. From prenatal to postpartum care: changes in obstetric health services during the COVID-19 pandemic. Texto Contexto Enferm. 2022;31:e20220206. doi: https://doi.org/10.1590/1980-265X-TCE-2022-0206en
22. Machado AV, Ferreira WE, Vitória MAÁ, Magalhães Júnior HM, Jardim LL, Menezes MAC, et al. COVID-19 and health systems in Brazil and around the world: effects on the working conditions and health of health workers. Ciênc Saúde Colet. 2023;28(10):2965-78. doi: https://dx.doi.org/10.1590/1413-812320232810.10102023
23. Mendes RB, Santos JMJ, Prado DS, Gurgel RQ, Bezerra FD, Gurgel RQ. Evaluation of the quality of prenatal care based on the recommendations prenatal and birth humanization program. Ciênc Saúde Coletiva. 2020;25(3):793-804. doi: https://doi.org/10.1590/1413-81232020253.13182018
24. Tork M, Sadeghi M, Asgarian-Omran H, Basirpour B, Ahmadi S, Ghasemzadeh F, et al. Assessment of simultaneous IgM, IgG avidity, and IgA testing in diagnosis of acute toxoplasmosis in pregnant women: a systematic review and meta-analysis study. BMC Pregnancy Childbirth. 2025;25(1):537. doi: https://doi.org/10.1186/s12884-025-07580-6
25. Laguardia MC, Carellos EVM, Andrade GMQ, Carneiro M, Januário JN, Vitor RWA. Evaluation of different cut-off points for IgG avidity and IgM in the diagnosis of acute toxoplasmosis in pregnant women participating in a congenital toxoplasmosis screening program. Rev Inst Med Trop S Paulo. 2024;66:e43. doi: https://doi.org/10.1590/S1678-9946202466043
26. Wesołowski R, Pawłowska M, Smoguła M, Szewczyk-Golec K. Advances and challenges in diagnostics of toxoplasmosis in HIV-infected patients. Pathogens. 2023;12(1):110. doi: https://dx.doi.org/10.3390/pathogens12010110
Downloads
Published
Data Availability Statement
The data come from confidential laboratory records provided by the Piauí Public Health Central Laboratory and are subject to ethical and institutional restrictions related to the patients' confidentiality and to data protection. It is for this reason that the full dataset cannot be made publicly available. Nevertheless, the aggregated and anonymized data sustaining the results and conclusions of this study are presented in the full text of the article.
Issue
Section
License
Copyright (c) 2026 Filipe Augusto de Freitas Soares, Rômulo Oliveira Barros, Kerla Joeline Lima Monteiro, Maria Regina Reis Amendoeira
This work is licensed under a Creative Commons Attribution 4.0 International License.
