Epidemiology

Toxoplasma gondii occurs worldwide, with a higher incidence in tropical areas. In the US, from 2009 to 2010 there was 10.1% seroprevalence in people 12 to 49 years old, a decrease from 1988 to 1994, at which it was 16%.[2] Seroprevalence in southern Europe is as high as 54%, which is thought to be due to ingestion of undercooked meat and poor kitchen hygiene. Seroprevalence in South America is also high, ranging from 43% to 73%, probably because of the effect of waterborne transmission, in addition to ingestion of undercooked meat. Age-specific prevalence has been decreasing in Europe over the past 30 to 40 years.[3] Seroprevalence is low in most Asian countries (1% in pregnant women in Korea, 10% in HIV-positive patients in Taiwan), although India (45%) and Malaysia (56%) have higher prevalence rates.[3] Rates of seroconversion in non-immune pregnant women range from 2.4 to 16 per 1000 in Europe;[4] in the UK the estimated rate is 2 per 1000.[5] In the US about 5 per 1000 non-immune women may acquire Toxoplasma during pregnancy, and the prevalence of congenital disease ranges from 1 to 10 per 10,000 live births.[6] Without treatment, infection during pregnancy results in congenital disease roughly 44% of the time, and appropriate treatment during pregnancy lowers the risk of congenital infection to 29%.[7][8]

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