Toxoplasma gondii and gender equity: advocating for a one health approach in Lebanon

Abstract

Toxoplasmosis, a zoonotic disease caused by the obligate intracellular protozoan Toxoplasma gondii , poses significant health risks, particularly for women of reproductive age, yet remains neglected in Lebanon's public health policies. This study aimed to assess awareness of toxoplasmosis among Lebanese participants and identify knowledge gaps about its prevalence, transmission routes, and health implications. The study involved 499 Lebanese participants across all provinces of Lebanon and examined factors influencing their awareness of toxoplasmosis, as well as related attitudes and readiness to act. Statistical analyses, including Mann–Whitney U, Kruskal–Wallis, and regression models, were used to assess the relationship between education, gender, and geographic location on these outcomes. Overall, > 80% of participants were classified as Unaware across prevalence, transmission, and clinical impact. Education was the only consistent determinant of awareness (Kruskal–Wallis H = 120.6 , 98.2 , and 87.5 for prevalence, transmission, and infection; all p < 0.001), whereas gender and location showed no significant effects. Among women, readiness to undergo serological testing had no significant predictors (logistic model pseudo R 2 = 0.018, p = 0.226), with only a non-significant trend for higher transmission awareness (β = 0.067, p = 0.104). The findings emphasize the urgent need for inclusive, gender-sensitive interventions that empower women and address disparities in public health outreach. The study, grounded in the One Health approach, offers actionable recommendations for improving disease awareness, establishing surveillance systems, and promoting preventive behaviors. These recommendations provide a comprehensive framework that can be adapted to similar global health challenges.