Research Article | DOI: https://doi.org/10.31579/2578-8965/311
Communicable Disease Surveillance Management, Health Surveillance Superintendence, Tocantins State Health Secretariat, Palmas, Tocantins, Brazil.
*Corresponding Author: Francisco das Chagas Teixeira Neto, Communicable Disease Surveillance Management, Health Surveillance Superintendence, Tocantins State Health Secretariat, Palmas, Tocantins, Brazil.
Citation: Francisco das Chagas Teixeira Neto, Janaína S. Santana, (2026), Epidemiological Profile and Spatial Distribution of Congenital Toxoplasmosis in the Period from 2020 To 2024 in the State of Tocantins, Brazil, J. Obstetrics Gynecology and Reproductive Sciences, 10(2) DOI:10.31579/2578-8965/311
Copyright: © 2026, Francisco das Chagas Teixeira Neto. This is an open-access article distributed under the terms of The Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 02 March 2026 | Accepted: 12 March 2026 | Published: 19 March 2026
Keywords: congenital toxoplasmosis; spatial distribution; epidemiological profile
Congenital toxoplasmosis remains a neglected disease in Tocantins, despite its high prevalence and potential to cause severe sequelae and disabilities in the population. This study aimed to describe the epidemiological profile of congenital toxoplasmosis cases from 2020 to 2024 among residents of Tocantins, based on sociodemographic characteristics and the spatial distribution of its occurrence.
Methods: This was an observational, ecological study with a quantitative approach, using secondary data obtained from the Notifiable Diseases Information System (SINAN) through the Tabnet/Datasus platform.
Results: During the study period, 798 cases of congenital toxoplasmosis were reported. The prevalence of the disease was 69 cases per 10,000 live births.
Most of the newborns reported with congenital toxoplasmosis were male, of mixed race (brown color), and residents of the Medio Norte Araguaia and Capim Dourado Health Regions. The main diagnostic tool was laboratory testing, and the vast majority of cases evolved to cure; however, there was a high rate of loss to follow-up over time.
Conclusion: Given the observed scenario, it is essential that public health policies for the prevention of toxoplasmosis in Tocantins be integrated with educational and social initiatives, with the aim of reducing inequalities and increasing the effectiveness of prevention efforts.
SUS : Unified Health System
SINAN : Notifiable Diseases Information System
DATASUS : Department of Information of the Unified Health System
IBGE : Brazilian Institute of Geography and Statistics
SINASC : Live Birth Information System
Toxoplasmosis is a worldwide zoonosis caused by an intracellular protozoan capable of infecting birds, humans and other mammals. It presents a varied clinical picture, from asymptomatic infection to extremely serious systemic manifestations [1,2].
Toxoplasma gondii, the etiologic agent of toxoplasmosis, has a life cycle with three main forms, all of which are capable of causing infection: tachyzoites (which occur during the acute phase or reactivation of the disease and are able to cross the placenta and infect the fetus); bradyzoites (which are found in the tissues of humans and all animals infected by the protozoan); and sporozoites, which are found inside oocysts (formed exclusively in the intestines of felines, their definitive hosts) [3].
The disease is transmitted in a variety of ways, either directly or indirectly, and can be via the oral route through the consumption of food and/or water contaminated with oocysts or meat and meat products containing tissue cysts. Another form of transmission is via the transplacental route, carried out by the active form of the parasite when the mother acquires the infection during pregnancy. In addition to these, there are other, rarer forms of transmission: inhalation through contaminated aerosols, through accidental inoculation, blood transfusion or through organ transplantation [4].
Most cases of toxoplasmosis are asymptomatic or present with very nonspecific symptoms, often confused with symptoms common to other diseases such as dengue fever, cytomegalovirus or infectious mononucleosis. Even in the absence of symptoms, the diagnosis of Toxoplasma gondii infection during pregnancy is extremely important, with the main objective of preventing congenital toxoplasmosis and its sequelae [5].
Special attention is justified due to the considerable probability of impact on the fetus. The anatomical and functional complications associated with congenital toxoplasmosis range from restricted intrauterine growth to clinical manifestations and sequelae such as microphthalmia, eye lesions, microcephaly, hydrocephalus, cerebral calcifications, pneumonitis, and hepatosplenomegaly and skin rash [3].
Complications in the fetus are more serious when the mother is infected early in pregnancy, and may cause spontaneous abortion, premature birth, neonatal death or malformations. Infected children may present the classic signs and symptoms of congenital toxoplasmosis (hydrocephalus, retinochoroiditis, cerebral calcification and mental retardation) or may be born normal and develop sequelae during childhood or even in adulthood [6].
It is speculated worldwide that for every ten thousand newborns, approximately 5(five) children suffer from congenital toxoplasmosis. Furthermore, it is the cause of 1.3 million years of life lost or years of life with disability in people diagnosed with the disease, due to sequelae caused by the disease, such as bilateral chorioretinitis, hydrocephalus and intracranial calcification [7].
In less severe cases, other eye lesions may appear, such as retinal degeneration and neurological damage. Regarding eye damage caused by toxoplasmosis, the typical manifestation is focal necrotizing retinochoroiditis accompanied by vitreous reaction, often associated with healed satellite lesions; there is a maculo discal predilection and the lesions are usually equal to or smaller than one disc diameter [8].
The risk of congenital transmission increases with the length of pregnancy. The risks of transmission to the fetus vary according to the period of infection. There is a 2% risk of transmission to the fetus in the periconceptional period; 15% in the first trimester; 25% in the second and 65% in the third trimester. In the last month of pregnancy, this risk can reach 100% of cases. Regarding the severity of the congenital disease, it is high when it occurs at the beginning of pregnancy and decreases with gestational age [9].
Treatment and monitoring of the disease are available, free of charge and comprehensively, through the Unified Health System (SUS), and serology for IgG and IgM of Toxoplasma gondii is mandatory in the 1st and 3rd trimesters during prenatal consultations [10]. If the pregnant woman's IgM and IgG tests are non-reactive, the serology should be repeated at the beginning of the 2nd and 3rd trimesters of pregnancy. This screening is essential, as it allows the identification of pregnant women susceptible to the disease for subsequent monitoring, enabling prevention and early detection measures [11].
Congenital toxoplasmosis has an estimated global incidence of 190,100 cases per year, representing approximately 1.5 cases per 1,000 live births. The main concern is the lack of uniformity in prenatal screening, not only between different countries, but also within the same country. In European countries, for example, only those with a high incidence of the disease have adopted prenatal screening, such as France, Austria and Slovenia. In the United Kingdom, where congenital toxoplasmosis is considered rare, there is not even a universal serological screening program [12].
In Brazil, the prevalence of toxoplasmosis is high, ranging from 64.9% to 91.6%, depending on the region. A high percentage (50-80%) of women of childbearing age are IgG positive. Between 20-50% of women of reproductive age are susceptible (IgG and IgM negative) and are at risk of acquiring the infection during pregnancy. Studies conducted in Brazil have shown that between 5-23 infected children are born for every 10,000 live births [12].
Congenital toxoplasmosis was included in the list of diseases subject to compulsory notification in 2016 through Ordinance No. 204, of February 17, 2016 [13]. However, until May 2020, there were no records of the disease in the Notifiable Diseases Information System (SINAN) of the Brazilian Ministry of Health, demonstrating how neglected the disease still was [14].
In view of the above, considering the significance and magnitude of congenital toxoplasmosis in the morbidity of the local population, especially its capacity to generate sequelae and consequent permanent disability, it is clear that there is a need to disclose the epidemiological profile, highlighting the distribution according to the triad of person, time and place of the disease in Tocantins, an essential condition for the construction of a plan aimed at reducing morbidity and organizing the Health Care Network to assist toxoplasmosis.
This is an observational, retrospective, ecological study with a quantitative approach, using SINAN as the data source, through the Tabnet database of the Department of Information of the Unified Health System (Datasus) and the Brazilian Institute of Geography and Statistics (IBGE).
Descriptive epidemiological studies aim to delimit the distribution of diseases or health-related circumstances, according to time, place and/or characteristics of individuals. It examines how the incidence or prevalence of a certain disease varies according to certain aspects such as sex, age, education, race, among others [15].
It is classified as retrospective, since the data on patients already exist and has a quantitative approach because it is related to the collection and analysis of estimated data on variables, identification, connections and deductions of a given population, using statistical techniques and consolidating the information obtained in tables, graphs, maps and others. Based on the information obtained through data processing, it is possible to outline the epidemiological profile of the disease in a certain period, favoring the development of control measures in public health leading to health promotion [16].
The study was carried out in the state of Tocantins, located in the northern region of Brazil. In the last census in 2022, its population was 1,511,460 inhabitants, with a population density of 5.45 inhabitants per square kilometer and a high human development index of 0.731 [17], distributed across eight health regions: “Bico do Papagaio”, “Medio Norte Araguaia”, “Cerrado Araguaia Tocantins”, “Cantão”, “Amor Perfeito”, “Capim Dourado”, “Island of Bananal” and “Sudeste”.
Exclusively secondary and anonymized data were used during the month of May 2025, collected directly from the SINAN database, a system responsible for storing notifications and investigations of cases of diseases and conditions present in the national list of diseases with compulsory notification, enabling health diagnoses to be carried out, contributing to identifying the epidemiological scenario of certain areas [18].
To include data in the study, all notifications that constituted the official database of congenital toxoplasmosis in SINAN were considered, with the municipality of residence reported as one of the 139 municipalities in the state of Tocantins, regardless of the place of diagnosis, in the period from 2020 to 2024.
To calculate prevalence, data on births registered in the Live Birth Information System (SINASC), collected on May 23, 2025, were used. Data from 2020 to 2023 are definitive, however, due to the SINASC data entry routine; data for 2024 are still partial and subject to change.
Among the variables available for public consultation through the Tabnet/Datasus system, those with the potential to achieve the study's purpose were selected, characterizing the epidemiological profile through the triad of person, time, and place. Thus, the following were used: year of notification, municipality of residence, age group, sex, classification, evolution, and confirmation criteria.
The response fields that were marked with the option “not applicable”, “ignored” or had no marking (empty) were grouped into the same category called “ignored”. The collected data were then tabulated, processed and organized in spreadsheets in Microsoft Office Excel 2016.
Since this is a study that used secondary public data as its source, made available by Datasus, and because it does not present variables that allow the identification of the individuals studied, authorization from the Research Ethics Committee is not required. However, as established in Resolution No. 466/2012 [19] and Resolution No. 510/2016 of the National Health Council [20].
During the period from 2020 to 2024, 798 cases of congenital toxoplasmosis were reported in the state of Tocantins in newborns under 1 year of age. In the same period, 115,013 births were registered in SINASC (partial data from 2024), representing a prevalence of approximately 69 cases per 10,000 births in the state.
The sociodemographic data of the participants in this study were analyzed and are presented in Table 1. The most frequent profile affected by congenital toxoplasmosis was male and brown children. It is important to highlight the high number of notifications that ignore the collection of data on race/color (n=106/13.3%).
Source: prepared by the author, 2025
Table 1: Sociodemographic characteristics of reported cases of Congenital Toxoplasmosis, Tocantins, Brazil, 2020-2024.
Regarding the spatial distribution of the disease in Tocantins (Table 2), there is a balance in the occurrence of cases, with records in all 08 (eight) Health Regions. The Health Region that had the majority of reported cases was “Medio Norte Araguaia” with 253 cases (31.6%), followed by “Capim
Dourado” which recorded 203 cases of congenital toxoplasmosis (25.4%). It is important to highlight that this leading role in the number of notifications is proportional to the population of these regions, the most populous in the State.
Source: prepared by the author, 2025
Table 2: Spatial distribution of notifications of Congenital Toxoplasmosis by Health Region, according to municipality of residence, Tocantins, Brazil, 2020-2024.
In the other Health Regions, the number of notifications also demonstrated coherence related to the population residing in them. There were 100 cases in “Bico do Papagaio” (12.5%); 99 in “Cerrado Araguaia Tocantins” (12.4%); 70 in “Island of Bananal” (8.7%) and the lowest number was reserved for the less populated regions: “Cantão” with 42 cases (5.6%); “Amor Perfeito” with 20 cases (2.5%) and “Sudeste” with 11 cases (1.3%).
Regarding temporality, in the period evaluated, 798 cases of congenital toxoplasmosis were reported in the state of Tocantins. The year with the highest number of notifications was 2023, with 33.8% of the total cases (n=270) and the year with the lowest occurrence was 2021 with 97 cases (12.1%). It is worth noting that this lower number of records may have been influenced by underreporting caused by the Covid-19 pandemic (Graph 1).
Source: prepared by the author, 2025
Graph 1: Distribution of reported cases of Congenital Toxoplasmosis by year of notification, Tocantins, Brazil, 2020 to 2024.
When analyzing the follow-up of reported cases (Table 3), it was observed that according to the classification, 54.8% (n=437) of the cases were confirmed, while 11.6% (n=92) were discarded. In addition, 4.6% (37) were inconclusive and 7.1% (n=57) were ignored.
Source: prepared by the author, 2025
Table 3: Distribution of reported cases of Congenital Toxoplasmosis, according to follow-up, Tocantins, Brazil, 2020 to 2024.
Furthermore, regarding the evolution of the cases, most mothers were cured, representing 43.1% (n=344) of the evolutions, 34.3% (n=274) of the cases had their clinical evolution ignored, 0.3% (n=2) evolved with deaths due to the condition and 0.4% (n=3) evolved with deaths due to another cause. Finally, considering the criteria used for notification, 51.4% (n=410) used laboratory criteria, 14.2% (n=113) used clinical-epidemiological criteria and 12.5% (n=100) ignored this data.
The present study aimed to outline the epidemiological profile and spatial distribution of congenital toxoplasmosis in the state of Tocantins, based on data collected between 2020 and 2024. The analysis of the results allowed us to identify demographic, temporal, spatial, and follow-up patterns associated with the occurrence of the disease, providing important support for the development of preventive strategies and interventions in the context of public health.
In the state of Tocantins, from 2020 to 2024, we had 798 notifications of the disease among 115,013 registered births, that is, a prevalence of approximately 69 infected children for every 10,000 live births, a value significantly higher than those found in a similar study in state of Piauí, which recorded the highest prevalence in 2022, with a total of 20.36 cases for every 10,000 live births [21].
Regarding the distribution by race, only 111 cases (14%) occurred in newborns classified as white, while there were 553 cases (69.3%) in mixed race and 10 cases (1.2%) in black. Although these numbers may partly reflect the demographic composition of Tocantins, it is possible that inequalities in access to information and health services influence epidemiological surveillance and treatment of the disease among different ethnic groups. A significant consideration regarding this variable was the high number of “Ignored” records found; 106 newborns did not have their race reported at the time of notification (13.3%).
The predominance of cases regarding race corroborates the findings of a recent study conducted in the Northeast Region of Brazil, where 74% were mixed race [22]and in a study in Piauí that indicated a mixed race predominance of 83.17% (21). However, it differs from a similar study carried out in Santa Catarina, where no statistically significant differences were identified between whites and blacks, yellows or browns [23].
The relative frequency of cases in the indigenous population of 2.1% (n=17) is proportionally coherent when compared with the constituent characteristics of the general population, where 1.32% of the state's population declared themselves indigenous in the last census carried out in 2022 [17].
Regarding the distribution of cases by sex of the universe of 798 cases, 415 (52%) cases were in boys and 383 in girls (48%), a situation similar to that found in a study in state of Bahia [24], of Piauí [21] and in Santa Catarina [23]. It is noted that the numbers of cases among men and women are very close, showing that there is no predilection between sexes.
In the opposite direction, a study carried out in the state of Pará found a predominance of 78.26% of cases of congenital toxoplasmosis in females in the population analyzed, however, a caveat should be noted regarding the sample size, which is not very representative due to the low number of individuals used for the calculation [25].
Regarding spatial distribution, according to the literature, there is still little known about any pattern that characterizes it; old records indicate that there would be a higher frequency of cases of toxoplasmosis in large cities than in small or rural cities (26). This finding was confirmed in Tocantins, where the health regions that house the largest urban centers, “Medio Norte Araguaia” with 253 cases (31.6%) and “Capim Dourado” with 203 cases (25.4%) were also those that reported the most cases.
However, more recent studies point to the predominance of cases of congenital toxoplasmosis in rural and peri-urban regions in a spatial analysis carried out in the state of Minas Gerais [27]. To justify the differences between the studies, it is assumed that the population in rural areas has less access to health services and, therefore, is not identified in studies with a design such as this research.
Considering the entire time frame used in the research, a linear increasing behavior was observed in the number of notifications between the years 2020 to 2023, with the exception of 2021, the year of the pandemic, a period in which there was a decrease in the number of diseases requiring compulsory notification, caused by the decrease in the demand for health services by the population, [28].
The incidence rate of congenital toxoplasmosis in 2020 was 4.8 per 1,000 LB, reaching a peak in 2023 with 11.7 cases for every 1,000 LB, an increase of approximately 144% in the period. This upward trend in the number of cases was also observed in a study carried out in the state of Bahia [24].
Regarding the diagnostic results, 437 cases (54.8%) were confirmed, while 92 (11.6%) were discarded and 37 (4.6%) remained inconclusive, which reinforces the importance of standardizing laboratory tests and adequate monitoring of newborns with suspected infection. The “Ignored/Blank” category recorded 57 cases (7.1%), indicating possible errors in data collection or filling, which compromises a more accurate analysis.
In the present analysis, it was observed that 51.4% of case confirmations were made using laboratory criteria, a percentage well below that found in a study carried out in Piauí of almost 90% of cases that used laboratory testing as a diagnostic tool [21].
Regarding the evolution of cases, 344 newborns (43.1%) were cured, which reflects the effectiveness of monitoring and treatment of toxoplasmosis, which is mainly carried out by Primary Care, since it is recognized that there is no exact standard for treating congenital toxoplasmosis.
The best strategy is to use measures based on health promotion on primary prevention in educational programs with dietary hygiene guidelines to reduce infection in pregnant women and, consequently, in the fetus [14].
The cure rate found in Tocantins, however, is low when compared to the results obtained in Piauí (84.68%), but in relation to deaths due to toxoplasmosis, in this same survey in Piauí, the rate was 1.28% (21), much higher than that found in Tocantins, which was 0.3% in the period evaluated, results that point to a low mortality rate directly associated with the disease.
However, 274 cases (34.3%) were classified as "Unknown/Blank", which indicates gaps in the registration and clinical monitoring of these patients. This scenario is worrying, as it compromises information on routines and standards established in the epidemiological surveillance of congenital toxoplasmosis in all health services, which would contribute to the production of a reliable profile and the expansion of knowledge about the disease throughout the country [29].
Finally, the high number of losses in follow-up of reported cases stands out, around 175 (21.9%) of the total. These losses may be associated with discards caused by a change in the initial diagnosis, by the failure to close the aforementioned notification or even by the exclusion of the investigation in SINAN.
This study outlined an epidemiological profile and spatial distribution of congenital toxoplasmosis in the state of Tocantins, demonstrating the relevance of the infection as a public health problem. The greater concentration of cases in the brown and black population suggests the need for more focused attention on more vulnerable populations and the implementation of public policies aimed at correcting historical distortions, especially in access to public health services in Brazil.
The data on clinical evolution demonstrate that most cases evolved to cure, which reflects the effectiveness of the available treatments. However, the significant number of cases without recorded outcomes suggests failures in monitoring and data collection, highlighting the importance of improving notification and epidemiological surveillance systems to ensure an adequate response.
Given the results presented, it is essential that public health policies for the prevention of toxoplasmosis in Tocantins be integrated with educational and social initiatives, with the aim of reducing inequalities and increasing the effectiveness of prevention. Expanding access to early diagnosis and treatment, combined with improvements in sanitation and nutrition conditions, is essential to contain the spread of the disease and prevent infant and fetal morbidity and mortality, in addition to contributing significantly to the reduction of permanent disabilities in the population.
Therefore, the fight against toxoplasmosis requires intersectoral efforts and an evidence-based approach, capable of meeting local specificities and promoting equity in access to health services. The continuation of awareness campaigns, combined with the training of health professionals and the improvement of surveillance systems, will be crucial to ensuring a positive impact in the long term, reducing not only the incidence of the disease, but also the associated social and economic impacts.
The authors declare that they have no economic interests or conflicts of interest.
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Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
