The global seroprevalence of Toxoplasma gondii in pigs: A systematic review and meta-analysis

Toxoplasmosis, caused by the protozoan parasite Toxoplasma gondii, is an important disease with worldwide distribution. Infection can occur from ingesting raw or undercooked infected meat, and among food animal species, pork is known to be one of the main sources of meat-borne infection. Here, we present results of the first systematic review and meta-analysis on the global T. gondii seroprevalence in pigs. PubMed/MEDLINE, Scopus, and EMBASE databases were comprehensively searched for relevant studies published between January 1, 1990 and October 25, 2018. We used a random effects model to calculate pooled seroprevalence estimates with 95% confidence intervals (CI) and analyzed data from five continents. We also conducted subgroup and meta-regression analyses to evaluate the effects of geographical and climate variables on pooled seroprevalence rates. Among 1542 publications identified, 148 studies containing 150 datasets were included in the meta-analysis, and comprised 148,092 pigs from 47 countries. The pooled global T. gondii seroprevalence in pigs was estimated to be 19% (95 %CI, 17-22%; 23,696/148,092), with the lowest seroprevalence in Europe (13%; 10-15%) and highest seroprevalence in Africa (25%; 17-34%) and North America (25%; 19-33%). The seropositivity rates in Asia and South America regions were (21%, 16-26%) and (23%; 17-30%), respectively. A significantly higher T. gondii seroprevalence was associated with higher mean annual temperature and lower geographical latitude. The presence of cats on farms was identified as a potential risk factor for T. gondii seropositivity (OR, 1.41; 95%CI, 1.00-2.02). Our findings highlight the importance of pigs as a possible source of human T. gondii infections.