Prevalence of Toxoplasmosis among the Human Population in Indonesia: A Systematic Review and Meta-Analysis

Abstract Background Toxoplasma gondii is a ubiquitous parasite that can cause significant complications when it infects pregnant women and immunocompromised patients. These complications include miscarriage, fetal abnormalities, and fatal cerebral toxoplasmosis. Despite its significance, the true burden of toxoplasmosis in Indonesia remains underexplored. Therefore, we aim to assess the prevalence of toxoplasmosis among the human population in Indonesia using serological, molecular, and histopathological examinations. In addition, we assessed whether the prevalence differed across geographical regions, populations, or population risk levels. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic review and meta-analysis of data retrieved from PubMed, Google Scholar, and Portal Garuda. We pooled prevalence data using the inverse-variance method and a random effects model. Heterogeneity was assessed using I2 statistics and Cochran’s Q test. Study quality was evaluated using a checklist for prevalence studies developed by the Joanna Briggs Institute. Publication bias was assessed using Doi plots and Luis Furuya-Kanamori (LFK) index. We performed subgroup analysis, meta-regression, and sensitivity analysis to explore sources heterogeneity and the robustness of the pooled estimates. Result In total, 52 studies were included in this study. The adjusted pooled seroprevalence was 58.13% (95% CI: 49.56–66.24%). We observed no subgroup differences based on study location, study population, population risk level, sample size, detection method, or study quality. The range of toxoplasmosis prevalence as measured via polymerase chain reaction and histopathological examination was 0–32.81% and 0%, respectively. Meta-analysis was not performed for molecular or histopathological data. Conclusion Toxoplasmosis is highly prevalent among the human population in Indonesia; however, our study mainly relied on studies with small-sample sizes. Furthermore, most of the studies were performed in Java; therefore, some high-quality population-based studies must be conducted in other regions of Indonesia to better estimate the prevalence of toxoplasmosis across the country.