Prevalence and Genetic Diversity of Toxoplasma gondii in Foods: A Global Systematic Review and Meta-Analysis

This study aimed to quantify the global prevalence of Toxoplasma gondii in foods and to evaluate its implications for food safety and public health. A comprehensive search of international databases was conducted from inception to May 17, 2025. A total of 34 eligible studies, encompassing 142 datasets from 22 countries across 5 continents, were included. Food items were categorized into eight groups: leafy vegetables, non-leafy vegetables, fruits and juices, mixed salads, raw meats, dairy products, eggs, and unspecified raw vegetables. Meta-analysis was performed using a random-effects model, with heterogeneity assessed via the I² statistic. The estimated global prevalence of T. gondii in food samples was 8.2% (95% confidence interval [CI]: 6.5-10.3%). Pooled prevalence was 4.1% (95% CI: 2.6-6.2%) when using microscopic techniques, but significantly higher at 9.9% (95% CI: 7.7-12.7%) with molecular methods. The highest contamination rates were found in raw meats (11.9%) and non-leafy vegetables (11.4%), followed by unspecified raw vegetables (7.1%), leafy vegetables (6.3%), mixed salads (5.4%), fruits and juices (5.1%), and dairy products (2%). Subgroup analyses demonstrated variability in prevalence across factors such as publication year, country, continent, country development status, Human Development Index, climate zone, sample size, and diagnostic method. Sensitivity analyses confirmed the robustness of the findings, and meta-regression showed that sample size was the only significant source of heterogeneity. Genotyping data, where available, indicated the presence of genotypes I and II in contaminated samples. The pooled prevalence of 8.2% offers a benchmark but should be interpreted cautiously due to study heterogeneity and uneven regional data.