Toxoplasmosis and epilepsy--systematic review and meta analysis.

Edgard B Ngoungou,Marie-Laure Dardé,Amandine Nzoghe,Pierre-Marie Preux,Devender Bhalla,Rima Mcleod

doi:10.1371/journal.pntd.0003525

Abstract

BackgroundToxoplasmosis is an important, widespread, parasitic infection caused by Toxoplasma gondii. The chronic infection in immunocompetent patients, usually considered as asymptomatic, is now suspected to be a risk factor for various neurological disorders, including epilepsy. We aimed to conduct a systematic review and meta-analysis of the available literature to estimate the risk of epilepsy due to toxoplasmosis.MethodsA systematic literature search was conducted of several databases and journals to identify studies published in English or French, without date restriction, which looked at toxoplasmosis (as exposure) and epilepsy (as disease) and met certain other inclusion criteria. The search was based on keywords and suitable combinations in English and French. Fixed and random effects models were used to determine odds ratios, and statistical significance was set at 5.0%.Principal findingsSix studies were identified, with an estimated total of 2888 subjects, of whom 1280 had epilepsy (477 positive for toxoplasmosis) and 1608 did not (503 positive for toxoplasmosis). The common odds ratio (calculated) by random effects model was 2.25 (95% CI 1.27–3.9), p = 0.005.ConclusionsDespite the limited number of studies, and a lack of high-quality data, toxoplasmosis should continue to be regarded as an epilepsy risk factor. More and better studies are needed to determine the real impact of this parasite on the occurrence of epilepsy.

Highlights

Epilepsy is a major chronic neurological disorder that affects about 70 million people worldwide [1]
A systematic literature search was conducted of several databases and journals to identify studies published in English or French, without date restriction, which looked at toxoplasmosis and epilepsy and met certain other inclusion criteria
Despite the limited number of studies, and a lack of high-quality data, toxoplasmosis should continue to be regarded as an epilepsy risk factor

Summary

Introduction

Epilepsy is a major chronic neurological disorder that affects about 70 million people worldwide [1]. Most of its burden is felt in low- and middle-income tropical countries, where a number of infections that are important risk factors for epilepsy, are predominantly reported [3,4,5]. We conducted a systematic review and meta-analysis of published data to estimate the risk of epilepsy due to toxoplasmosis. The chronic infection in immunocompetent patients, usually considered as asymptomatic, is suspected to be a risk factor for various neurological disorders, including epilepsy. We aimed to conduct a systematic review and meta-analysis of the available literature to estimate the risk of epilepsy due to toxoplasmosis

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