infection risk among pregnant people and congenital toxoplasmosis incidence in Japan.

Acute infection with in pregnant people can lead to vertical transmission to the foetus and congenital toxoplasmosis. As part of risk assessment, the epidemiology of toxoplasmosis among pregnant people must be quantitatively elucidated. Herein, we investigated the risk of primary infection during pregnancy in Japan, estimating the incidence of infection among pregnant people as well as that of congenital toxoplasmosis. We used a compartment model that captured the infection dynamics in pregnant people, analysing prescription data for spiramycin in Japan, together with local serological testing results and the screening rate of primary infection during pregnancy. The nationwide risk of infection pregnant people in Japan was estimated to be 0.016% per month. Among prefectures investigated, the risk estimate was highest in Tokyo with 0.030% per month. Nationally, the number of infections among pregnant people in the years 2019, 2020, and 2021 was estimated to be 1507, 1440, and 1388 infections, respectively. The nationwide number of cases of congenital toxoplasmosis in each year was estimated at 613, 588, and 567 cases, respectively. Our study indicated that infection continues to place a substantial burden on public health in Japan.