Increase in congenital toxoplasmosis notifications in Brazil in the post-COVID-19 pandemic context: time-series analysis and discussion of possible explanatory factors

Abstract

This study aimed to analyze the temporal trend of congenital toxoplasmosis notifications in Brazil between 2019 and 2024, investigating case patterns, diagnostic criteria, outcomes, and regional and sociodemographic inequalities. It is a descriptive, ecological time-series study based on secondary data from the Notifiable Diseases Information System (SINAN), provided by DATASUS. Between 2019 and 2024, a 151% increase in the number of notified cases was recorded, with more pronounced growth starting in 2022 and an annual average 107% higher in the post-pandemic period (2022–2024) compared to the pre-pandemic period (2019–2020). Deaths increased by 105%, yet the case-fatality rate remained stable. Most cases were confirmed via laboratory criteria (65.3%), maintaining a similar proportion throughout the historical series. Greater proportional growth was observed among Black individuals, along with a concentration of cases in the Northeast region. The study concludes that there was a sustained increase in notifications during the post-pandemic period without a proportional rise in case-fatality, suggesting a combined influence of expanded diagnostic capacity and the pandemic's indirect repercussions on prenatal care, thereby reinforcing the need to strengthen epidemiological surveillance and maternal-child care.