Toxoplasmosis in immunocompromised patients in Iran: a systematic review and meta-analysis.

Ehsan Ahmadpour,Mohsen Aarabi,Azar Shokri,Mahdi Sharif,Ahmad Daryani,Azadeh Mizani,Mohammad Taghi Rahimi,Shahabeddin Sarvi

doi:10.3855/jidc.4796

Abstract

Although toxoplasmosis in immunocompetent individuals is generally asymptomatic, in immunocompromised patients (HIV/AIDS, cancer, and transplant patients), it can lead to serious pathological effects. This study included a systematic review and meta-analysis to comprehensively assess the seroprevalence rate of Toxoplasma infection in immunocompromised patients in Iran. Electronic English and Persian databases (PubMed, Google Scholar, ScienceDirect, Scopus, Magiran, Scientific Information Database [SID], IranMedex, and IranDoc), parasitology congresses, and projects and theses of Iranian medical universities, were systematically searched from 1997 to 2013 (published or unpublished data). In this paper, several studies that used serological methods for diagnosis of toxoplasmosis were selected. Analysis of seroprevalence estimates was pooled using a random-effects meta-analysis. Twenty-two studies, comprising 2,805 individuals, were included in the meta-analysis. Overall seroprevalence rate of Toxoplasma infection in Iranian immunocompromised patients was 50.01% (95% confidence interval, 43.85 to 56.17); however, there was significant heterogeneity among study groups. The results showed that seroprevalence rate of toxoplasmosis among transplant recipients, HIV/AIDS, and cancer patients in Iran was 55.1%, 50.05%, and 45.06%, respectively. In addition, IgM seroprevalence rate was estimated to be 4.85% (95% confidence interval, 2.22 to 8.41). This systematic review and meta-analysis identified a high seroprevalence rate of Toxoplasma infection among immunocompromised patients (50%). Consideration of management, design and provision of appropriate control measures of toxoplasmosis is highly recommended.

Highlights

IntroductionToxoplasmosis is an infection with worldwide distribution caused by the protozoan parasite
Toxoplasmosis is an infection with worldwide distribution caused by the protozoan parasiteToxoplasma gondii (T. gondii), which infects all warm-blooded vertebrates and imposes a major burden on human and animal health [1]
The results showed that seroprevalence rate of toxoplasmosis among transplant recipients, HIV/AIDS, and cancer patients in Iran was 55.1%, 50.05%, and

Summary

Introduction

Toxoplasmosis is an infection with worldwide distribution caused by the protozoan parasite. Toxoplasma gondii (T. gondii), which infects all warm-blooded vertebrates and imposes a major burden on human and animal health [1]. The global seroprevalence in humans and animals varies greatly among countries, ranging from 6.7% in Korea to. Toxoplasma gondii can pass from one host to another, through environmental transmission (food and water contaminated with oocysts), infected tissue consumption (raw or undercooked meat), or transplacental transmission. Several methods are employed for diagnosis of toxoplasmosis, which routinely relies on serological methods. Serology-based diagnosis tools such as enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence assay (IFA) are considered to be the gold standard for the detection of Toxoplasma-specific antibodies (IgG or IgM) [1]

Results

Discussion

Conclusion