The Seroprevalence of Toxoplasma gondii in Chinese Population With Cancer: A Systematic Review and Meta-analysis.

Abstract

Toxoplasmosis is fatal in the immunocompromised individuals such as cancer patients with chemotherapy. Clinical toxoplasmosis in cancer patients is a great public health concern in China. We performed this meta-analysis to assess the seroprevalence and odds ratios (ORs) of Toxoplasma gondii in Chinese population with cancer compared with those without.A methodical literature search was conducted with the help of the PubMed, Web of Knowledge, Embase, Chinese Web of Knowledge, Wanfang, and Chongqing VIP database. Case-control studies published from their inception until April 2015, reporting the seroprevalence of T. gondii in Chinese population with cancer, were covered as well. The nonweighted prevalence, pooled random-effects estimates of ORs, and 95% confidence intervals (CIs) were all calculated.Nineteen studies including 4493 cases and 6797 controls were incorporated in the meta-analysis. The overall seroprevalence of T. gondii was higher in population with cancer compared with those without ((20.59% vs 6.31%, P < 0.001; OR 3.90, 95% CI 3.00–5.07). The OR of T. gondii in cancer patients is further subgrouped according to publication year, sample size, and diagnostic methods. The pooled OR estimates were 4.80 (95% CI 2.57–8.99) from 1991 to 1999, 4.96 (95% CI 3.03–8.12) during 2000 to 2005, and 2.94 (95% CI 2.46–3.50) during 2006 to 2015. The pooled OR estimates were 6.16 (95% CI 3.87–9.78) when the sample size was below 400, 5.37 (95% CI 3.84–7.53) when the sample size was between 400 and 500, and 2.58 (95% CI 2.17–3.07) when the sample size was above 500. The pooled OR estimates were 5.50 (95% CI 3.98–7.62) by using indirect hemagglutination assay method, and 3.15 (95% CI 2.67–3.72) by using enzyme-linked immunosorbent assay method.The meta-analysis study found Chinese population with cancer had higher seroprevalence rates of T. gondii compared with those without.