Title: Human toxoplasmosis in Mozambique: Gaps in knowledge and research opportunities

Abstract

Toxoplasmosis is a parasitic zoonotic disease caused by the Toxoplasma gondii zoonosis that afflicts humans worldwide and wild and domestic warm-blooded animals. In immunocompetent individuals, the acute phase of infection presents transient low or mild symptoms that remain unnoticed. Although the lifelong persistence of the dormant form of this parasite can lead to different toxoplasmosis clinical forms in immunocompetent individuals and immunocompromised patients and be related to neuropsychiatric disorders and neurodegenerative diseases. In immunocompromised patients, Toxoplasma is a life-threatening opportunistic infection, which can result from the reactivation of latent infection or primary infection. Moreover, congenital toxoplasmosis, which results from the transplacental passage of tachyzoites into the fetus during a pregnant primary infection can lead to miscarriage, stillbirth, or ocular and neurologic disease, and neurocognitive deficits in the newborns. Thus, the present review aims to address the current knowledge of Toxoplasma infection and toxoplasmosis in Africa and especially in Mozambique, stressing the importance of identifying risk factors and promote awareness among the population, assessing the gaps in knowledge and define research priorities. In Mozambique, and in general in Southern African countries, clinical disease and epidemiological data have not yet been entirely addressed in addition to the implications of T. gondii infection in immunocompetent individuals, in pregnant women, and its relation with neuropsychiatric disorders. The main gaps in knowledge in Mozambique include lack of awareness of the disease, lack of diagnostic methods in health facilities, lack of genetic data, and lack of control strategies.