Abstract
BackgroundAlthough they are declining worldwide, neurotropic parasitic diseases are still common in developing and emerging countries. The aim of this study was to estimate the pooled prevalence and pooled association measures of comorbidities between mental disorders (anxiety, depression, bipolar disorder, and schizophrenia) and neurotropic parasitic diseases (malaria, cysticercosis, toxoplasmosis, human African trypanosomiasis, Chagas disease, and human toxocariasis) in developing and emerging countries.MethodsAs the first meta-analysis on this topic, this study was performed in accordance with PRISMA guidelines. The protocol was registered in PROSPERO (N°CRD42017056521). The Medline, Embase, Lilacs, and Institute of Epidemiology and Tropical Neurology databases were used to search for articles without any restriction in language or date. We evaluated the quality of studies independently by two investigators using the Downs and Black assessment grid and pooled estimates using the random-effects method from CMA (Comprehensive Meta Analysis) Version 3.0.ResultsIn total, 18 studies published between 1997 and 2016 met our inclusion criteria. We found that the prevalence of anxiety and depression in people suffering from Chagas disease and/or neurocysticercosis was 44.9% (95% CI, 34.4–55.9). In 16 pooled studies that included 1782 people with mental disorders and 1776 controls, toxoplasmosis and/or toxocariasis were associated with increased risk of schizophrenia and/or bipolar disorders (odds ratio = 2.3; 95% CI, 1.7–3.2). Finally, toxocariasis and/or toxoplasmosis were associated with an increased risk of the onset of schizophrenia (odds ratio = 2.4; 95% CI, 1.7–3.4).ConclusionOur pooled estimates show that the associations between diseases studied are relatively high in developing and emerging countries. This meta-analysis supports the hypothesis that toxoplasmosis could be the cause of schizophrenia. These findings could prove useful to researchers who want to further explore and understand the associations studied.
Highlights
They are declining worldwide, neurotropic parasitic diseases are still common in developing and emerging countries
Neurotropic parasitic diseases such as malaria, cysticercosis, toxoplasmosis, human African trypanosomiasis (HAT), Chagas disease, and human toxocariasis have a predilection for infesting the central nervous system, which can lead to neurological disorders
From the included analytical studies, we found that the pooled odds ratio of the association of schizophrenia and/or bipolar disorders and toxoplasmosis and/or toxocariasis in cases versus controls after sensivity analyses did not changes
Summary
They are declining worldwide, neurotropic parasitic diseases are still common in developing and emerging countries. The aim of this study was to estimate the pooled prevalence and pooled association measures of comorbidities between mental disorders (anxiety, depression, bipolar disorder, and schizophrenia) and neurotropic parasitic diseases (malaria, cysticercosis, toxoplasmosis, human African trypanosomiasis, Chagas disease, and human toxocariasis) in developing and emerging countries. Among the public health issues typically faced by developing and emerging countries (all non high income countries according to World Bank rankings) [1], neurotropic parasitic diseases are very common [2]. Neurotropic parasitic diseases such as malaria, cysticercosis, toxoplasmosis, human African trypanosomiasis (HAT), Chagas disease, and human toxocariasis have a predilection for infesting the central nervous system, which can lead to neurological disorders. It is estimated that mental disorders rank third among the most frequent diseases encountered in the world, just after cancer and cardiovascular diseases [14]
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