Toxoplasmosis landscape: a systematic review and meta-analysis of seroprevalence in healthy and non-healthy individuals in Sudan (1990-2025).

Background: Human toxoplasmosis is a widespread zoonotic infection with significant public health implications, particularly in Sudan, where the disease burden is high. However, the overall prevalence of Toxoplasma gondii infection in the country remains unclear. This systematic review and meta-analysis aimed to estimate the pooled seroprevalence of human toxoplasmosis in Sudan and identify associated risk factors.

Methods: A comprehensive search was conducted in English and Arabic databases for studies published before February 28, 2025, following PRISMA guidelines. The meta-analysis included 60 studies with 10,866 participants from different regions of Sudan.

Results: The pooled seroprevalence of human toxoplasmosis was 36% (95% CI: 31-41%), with significant heterogeneity (I² = 97.29%, P < 0.0001). Hemodialysis patients exhibited the highest prevalence (56%), followed by women of childbearing age (48%) and HIV patients (42%). Geographically, northern Sudan had the highest prevalence (46%), while western Sudan had the lowest (17%). The latex agglutination test (LAT) was the most frequently used diagnostic method (56.7% of cases). Temporal analysis suggested that the prevalence of toxoplasmosis has slightly declined in recent years, likely due to improved hygiene, sanitation, and increased use of antiparasitic treatments.

Conclusion: Toxoplasmosis remains highly endemic in Sudan, with certain groups-including males, hemodialysis patients, women of childbearing age, HIV patients, and workers exposed to animals-at heightened risk. Targeted public health interventions are necessary to reduce the disease burden among high-risk populations.