# APBA Kısa Özet

A systematic review and meta-analysis synthesizing data from 19 reports examined the seroprevalence of Toxoplasma gondii, rubella, cytomegalovirus (CMV), herpes simplex virus (HSV), and syphilis among pregnant women and infants in Malaysia. The analysis reveals a high overall burden of TORCH infections, with significant variability between studies.

# Çalışma neyi araştırdı?

This research aimed to determine the current seroprevalence of five major TORCH agents—Toxoplasma gondii, rubella, cytomegalovirus, herpes simplex, and syphilis—in pregnant women and infants in Malaysia. By aggregating data from studies published up to November 2025, the review provides the first comprehensive estimate of these infections in the target populations.

# Yöntem

The review followed systematic review methodology. Researchers identified 19 relevant studies from databases including PubMed, Scopus, and Web of Science. Data were extracted on study design, population characteristics, and seroprevalence rates. Pooled prevalence estimates were calculated using random-effects models due to expected heterogeneity. Subgroup analyses were performed based on geographic region and study year. The quality of included studies was assessed using standard tools, and risk of bias was evaluated.

# Temel bulgular

The meta-analysis of 19 reports involving pregnant women and infants in Malaysia revealed the following pooled seroprevalence rates:

  • Toxoplasma gondii: 32.5% (95% CI: 16.6–53.8%), with extreme heterogeneity (I² = 99.4%).
  • Rubella: 28.7% (95% CI: 15.2–45.6%).
  • Cytomegalovirus: 55.2% (95% CI: 38.1–71.5%).
  • Herpes simplex: 48.9% (95% CI: 32.1–65.9%).
  • Syphilis: 1.1% among pregnant women and 4% among infants.

# Bulgular ne anlama geliyor?

The high seroprevalence of TORCH infections in Malaysia indicates a significant public health concern. Cytomegalovirus showed the highest prevalence, suggesting widespread exposure. The extreme heterogeneity (I² = 99.4%) for Toxoplasma gondii suggests that seroprevalence varies considerably across different Malaysian states, populations, and time periods. The low syphilis rates reflect effective public health interventions, but the high rates of viral infections underscore the need for targeted prevention strategies. Screening pregnant women is critical to identifying infections early and preventing vertical transmission to the neonate, which can lead to congenital defects, developmental delays, and neonatal morbidity.

# Klinik önem

The results emphasize that TORCH infections are highly prevalent among pregnant women in Malaysia. Routine prenatal screening for these infections is essential to enable timely intervention, such as maternal treatment, close fetal monitoring, and neonatal care, to mitigate the risk of congenital transmission. Healthcare providers should consider integrating TORCH screening into standard antenatal care protocols, particularly in regions with limited access to specialized diagnostic services.

# Sınırlılıklar

Several limitations should be considered when interpreting these findings. The included studies span from 2010 to 2025, potentially reflecting changing epidemiological patterns over time. High heterogeneity (I² = 99.4%) indicates substantial variability between included studies, limiting the robustness of pooled estimates. The meta-analysis included a small number of studies (n=19), which may affect the precision of the combined seroprevalence rates. Significant publication bias or grey literature may not have been fully captured. Variability in diagnostic methods across studies (e.g., different serological assays) may affect the comparability of seroprevalence estimates. Additionally, most studies were conducted in specific regions, limiting the generalizability of findings to the entire Malaysian population.