Evaluation of TORCH Screening in Pregnant Women in Sebha, Libya: Awareness, Practices, and Service Delivery Gaps

Background and Aims: Maternal TORCH infections (Toxoplasma, Other, Rubella, Cytomegalovirus, Herpes) are under-recognized causes of adverse pregnancy outcomes in low-resource settings. This study aimed to assess knowledge of TORCH infections and the uptake of screening among pregnant women in Sebha, Libya, and to identify predictors of completing the full TORCH testing panel. Methods: In a cross-sectional survey conducted at Sebha Medical Center (August–September 2025), 80 antenatal attendees were interviewed regarding socio-demographics, obstetric history, TORCH awareness, and risk behaviors. Sera were assayed for Toxoplasma, Rubella, and CMV IgG/IgM using mini-VIDAS. A complete panel comprised six assays. Descriptive statistics, chi-square/Fisher’s tests, and logistic regression were used to evaluate correlates and predictors of complete screening. Results: The median age was 32 years (17–43); 72.5% had university education, and 50% reported prior miscarriage. Only 6.2% had heard of "TORCH," none recognized CMV, and 55% lived with a child <3 years. Safer toxoplasmosis practices were common (98.7% handwashing after raw meat; 12.5% cat ownership). Rubella IgG was performed in all participants (98.8% immune), while CMV IgM was negative in all. Only 20% received the full six-test panel, with common omissions of Rubella IgM and CMV IgG. Complete testing was more frequent with ≥4 ANC visits (22.4% vs 7.7%) and among non-city residents. Conclusion: TORCH awareness was extremely low, and screening was inconsistent despite high rubella immunity. Standardizing first-visit TORCH testing, providing targeted CMV/toxoplasmosis counseling, and arranging postpartum rubella vaccination for non-immune women are essential to reduce preventable congenital infections