Estimates of Toxoplasmosis Incidence Based on Healthcare Claims Data, Germany, 2011-2016

Abstract

Toxoplasmosis is a zoonotic infection contracted through Toxoplasma gondii-contaminated food, soil, or water. Seroprevalence in Germany is high, but estimates of disease incidence are scarce. We investigated incidences for various toxoplasmosis manifestations using anonymized healthcare claims data from Germany for 2011-2016. Patients with a toxoplasmosis diagnosis during the annual observational period were considered incident. The estimated incidence was adjusted to the general population age/sex distribution. We estimated an annual average of 8,047 toxoplasmosis patients in Germany. The average incidence of non-pregnancy-associated toxoplasmosis patients was 9.6/100,000 population. The incidence was highest in 2011, at 10.6 (95% CI 9.4-12.6)/100,000 population, and lowest in 2016, at 8.0 (95% CI 7.0-9.4)/100,000 population. The average incidence of toxoplasmosis during pregnancy was 40.3/100,000 pregnancies. We demonstrate a substantial toxoplasmosis disease burden in Germany. Public health and food safety authorities should implement toxoplasmosis-specific prevention programs.

Keywords: Germany; Toxoplasma gondii; food safety; healthcare claims data; incidence; parasites; toxoplasmosis; zoonoses.

Figure 1

Visualization of different inclusion and exclusion definitions for study of toxoplasmosis incidence based on healthcare claims data, Germany, 2011–2016.

Figure 2

Visualization of different inclusion and exclusion definitions of recurring medical claims and identification of underlying conditions for study of toxoplasmosis incidence based on healthcare claims data, Germany, 2011–2016.

Figure 3

Toxoplasmosis disease incidence by federal state in Germany, 2016. Error bars indicate 95% CIs. No estimates were available for Bremen, Saarland, and Thüringen. NA, not available.