Toxoplasmosis in the Autonomous Province of Vojvodina, Serbia: A 29-year surveillance data analysis (1997-2025)

Abstract

Background/Aim. Toxoplasmosis is a widespread zoonotic infection with significant public health implications, particularly for pregnant women and immunocompromised individuals. The aim of the study was to analyze the epidemiological characteristics and temporal trends of toxoplasmosis in the Autonomous Province (AP) of Vojvodina, Serbia, over 29 years (1997-2025). Methods. A descriptive, population-based study was conducted using routine surveillance data on reported toxoplasmosis cases for the 1997-2025 period. Incidence rates were calculated per 100,000 inhabitants. Demographic, topographic, and seasonal differences among patients were analyzed. The association between the reported incidence of toxoplasmosis and climatic variables was evaluated using Spearman’s correlation coefficient. Results. A total of 389 cases of toxoplasmosis were reported during the study period, with no fatal outcomes registered. The annual reported incidence ranged from 0.06 to 1.49 per 100,000 inhabitants. Segmented log-linear regression analysis identified two statistically significant trend changes in the reported toxoplasmosis incidence: a significant increase during the 2001-2007 period [annual percent change (APC) = 32.1%, 95% confidence interval (CI): 14.0-53.0; p = 0.005] and a decrease during the 2015-2019 period (APC = -35.1%, 95% CI: -49.8−-16.2; p = 0.013). The highest proportion of cases was observed in the 15-29 years (34.19%) age group, followed by 0-14 years (23.14%) and 30-39 years (21.59%). Females accounted for 60.15% of cases and were significantly older than males (30.56 ± 14.74 vs. 22.88 ± 15.02 years; p < 0.001). The majority of cases (66.07%) were recorded in urban areas. No statistically significant difference was found in seasonal distribution, although the highest proportion of cases (38.30%) occurred in the period January-March. A statistically significant negative correlation was found between reported incidence of toxoplasmosis and average temperature (ρ = -0.5111, p = 0.0046), whereas correlations with precipitation, humidity, and the number of rainy days were not statistically significant (p > 0.05). Conclusion. The reported incidence of toxoplasmosis in the AP of Vojvodina showed a declining trend over the observed period. Despite the decrease in reported incidence, enhancing surveillance, improving the recognition of congenital toxoplasmosis, and considering standardized prenatal screening could contribute to more effective prevention and early detection of congenital infection.