-
Malaria Journal Jul 2020Severe complications among patients with Plasmodium malariae infection are rare. This is the first systematic review and meta-analysis demonstrating the global... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Severe complications among patients with Plasmodium malariae infection are rare. This is the first systematic review and meta-analysis demonstrating the global prevalence and mortality of severe P. malariae infection in humans.
METHODS
The systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All research articles published on the severity and mortality of P. malariae infection cases in humans were retrieved from three public databases: PubMed, Scopus, and ISI Web of Science. The pooled prevalence estimate and 95% confidence interval (CI) of complications in patients with P. malariae malaria was analysed using the random-effects model provided in Stata software. The pooled odds ratio (OR) and 95% CI of severe malaria for P. malariae infection and Plasmodium falciparum infection were analysed using Review Manager software.
RESULTS
Six studies were used to estimate the pooled prevalence of severe P. malariae malaria. Out of 10,520 patients infected with P. malariae, the pooled prevalence estimate of severe P. malariae infection was 3% (95% CI 2-5%), with high heterogeneity (I: 90.7%). Severe anaemia (3.32%), pulmonary complications (0.46%), and renal impairments (0.24%) were the most common severe complications found in patients with P. malariae infection. The pooled proportion of severe anaemia for P. malariae infection and P. falciparum infection was comparable among the four included studies (OR: 0.74, 95% CI 0.22-2.45, I = 98%). The pooled proportion of pulmonary complications was comparable between patients with P. malariae infection and those with P. falciparum infection among the four included studies (OR: 1.44; 95% CI 0.17-12.31, I: 92%). For renal complications, the funnel plot showed that the pooled proportion of renal complications for P. malariae infection and P. falciparum infection was comparable among the four included studies (OR: 0.94, 95% CI 0.18-4.93, I: 91%). The mortality rate of patients with P. malariae infection was 0.17% (18/10,502 cases).
CONCLUSIONS
This systematic review demonstrated that approximately two percent of patients with P. malariae infection developed severe complications, with a low mortality rate. Severe anaemia, pulmonary involvement, and renal impairment were the most common complications found in patients with P. malariae infection. Although a low prevalence and low mortality of P. malariae infection have been reported, patients with P. malariae infection need to be investigated for severe anaemia and, if present, treated aggressively to prevent anaemia-related death.
Topics: Humans; Malaria; Plasmodium malariae; Prevalence
PubMed: 32736635
DOI: 10.1186/s12936-020-03344-z -
PLoS Neglected Tropical Diseases Apr 2019A few studies investigated the relationship between toxoplasmosis and mental disorders, such as obsessive compulsive disorder (OCD). However, the specific nature of the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
A few studies investigated the relationship between toxoplasmosis and mental disorders, such as obsessive compulsive disorder (OCD). However, the specific nature of the association between Toxoplasma gondii (T. gondii) infection and OCD is not yet clear. The aim of this study was to collect information on the relationship between OCD and toxoplasmosis and assess whether patients with toxoplasmosis are prone to OCD.
METHODS
For the purpose of this study, 6 major electronic databases and the Internet search engine Google Scholar were searched for the published articles up to July 30th, 2018 with no restriction of language. The inverse variance method and the random effect model were used to combine the data. The values of odds ratio (OR) were estimated at 95% confidence interval (CI).
RESULTS
A total of 9 case-control and 3 cross-sectional studies were included in our systematic review. However, 11 of these 12 articles were entered into the meta-analysis containing 9873 participants, out of whom 389 were with OCD (25.96% positive for toxoplasmosis) and 9484 were without OCD (17.12% positive for toxoplasmosis). The estimation of the random effect model indicated a significant common OR of 1.96 [95% CI: 1.32-2.90].
CONCLUSION
This systematic review and meta-analysis revealed that toxoplasmosis could be as an associated factor for OCD (OR = 1.96). However, further prospective investigations are highly recommended to illuminate the underlying pathophysiological mechanisms of T. gondii infection in OCD and to better investigate the relationship between OCD and T. gondii infection.
Topics: Antibodies, Protozoan; Case-Control Studies; Cross-Sectional Studies; Disease Susceptibility; Humans; Obsessive-Compulsive Disorder; Odds Ratio; Toxoplasma; Toxoplasmosis
PubMed: 30969961
DOI: 10.1371/journal.pntd.0007306 -
PloS One 2024Toxoplasma gondii (T. gondii) is a worldwide distributed protozoan parasite which has infected a wide range of warm-blooded animals and humans. The most common form of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Toxoplasma gondii (T. gondii) is a worldwide distributed protozoan parasite which has infected a wide range of warm-blooded animals and humans. The most common form of T. gondii infection is asymptomatic (latent); nevertheless, latent toxoplasmosis can induce various alterations of sex hormones, especially testosterone, in infected humans and animals. On the other hand, testosterone is involved in behavioral traits and reproductive functions in both sexes. Hence, the purpose of this systematic review is to summarize the available evidence regarding the association between T. gondii infection and testosterone alteration.
METHODS
In the setting of a systematic review, an electronic search (any date to 10 January 2023) without language restrictions was performed using Science Direct, Web of Science, PubMed, Scopus, and Google Scholar. The PRISMA guidelines were followed. Following the initial search, a total of 12,306 titles and abstracts were screened initially; 12,281 were excluded due to the lack of eligibility criteria or duplication. Finally, 24 articles met the included criteria. A mean±standard deviation (SD) was calculated to assess the difference of testosterone between T. gondii positive and T. gondii negative humans. The possibility of publication bias was assessed using Egger's regression. P-value < 0.05 was considered statistically significant.
RESULTS
This systematic review identified 24 articles (18 studies in humans and six studies in animals). Most human studies (13 out of 19) reported an increased level of testosterone following latent toxoplasmosis in males, while three studies reported decreased levels and two studies reported an insignificant change. Eleven articles (seven datasets in males and seven datasets in females) were eligible to be included in the data synthesis. Based on the random-effects model, the pooled mean± SD of testosterone in T. gondii positive than T. gondii negative was increased by 0.73 and 0.55 units in males and females, respectively. The Egger's regression did not detect a statistically significant publication bias in males and females (p = value = 0.95 and 0.71), respectively. Three studies in male animals (rats, mice, and spotted hyenas) and two studies in female animals (mice and spotted hyenas) reported a decline in testosterone in infected compared with non-infected animals. While, one study in female rats reported no significant changes of testosterone in infected than non-infected animals. Moreover, two studies in male rats reported an increased level of testosterone in infected than non-infected animals.
CONCLUSIONS
This study provides new insights about the association between T. gondii infection and testosterone alteration and identifies relevant data gaps that can inform and encourage further studies. The consequence of increased testosterone levels following T. gondii infection could partly be associated with increased sexual behavior and sexual transmission of the parasite. On the other hand, declining testosterone levels following T. gondii infection may be associated with male reproductive impairments, which were observed in T. gondii-infected humans and animals. Furthermore, these findings suggest the great need for more epidemiological and experimental investigations in depth to understand the relationship between T. gondii infection and testosterone alteration alongside with future consequences of testosterone alteration.
Topics: Male; Humans; Female; Animals; Mice; Rats; Testosterone; Hyaenidae; Toxoplasmosis; Toxoplasma; Reproduction; Seroepidemiologic Studies
PubMed: 38568993
DOI: 10.1371/journal.pone.0297362 -
International Journal of Environmental... Mar 2023Type-1 diabetes, an autoimmune disease characterized by damage to pancreatic insulin-producing beta cells, is associated with adverse renal, retinal, cardiovascular, and... (Meta-Analysis)
Meta-Analysis Review
Type-1 diabetes, an autoimmune disease characterized by damage to pancreatic insulin-producing beta cells, is associated with adverse renal, retinal, cardiovascular, and cognitive outcomes, possibly including dementia. Moreover, the protozoal parasite has been associated with type-1 diabetes. To better characterize the association between type-1 diabetes and infection, we conducted a systematic review and meta-analysis of published studies that evaluated the relationship between type-1 diabetes and infection. A random-effects model based on nine primary studies (total number of participants = 2655) that met our inclusion criteria demonstrated a pooled odds ratio of 2.45 (95% confidence interval, 0.91-6.61). Removing one outlying study increased the pooled odds ratio to 3.38 (95% confidence interval, 2.09-5.48). These findings suggest that infection might be positively associated with type-1 diabetes, although more research is needed to better characterize this association. Additional research is required to determine whether changes in immune function due to type-1 diabetes increase the risk of infection with infection with increases the risk of type-1 diabetes, or both processes occur.
Topics: Humans; Risk Factors; Toxoplasmosis; Toxoplasma; Diabetes Mellitus, Type 1; Odds Ratio; Seroepidemiologic Studies
PubMed: 36901457
DOI: 10.3390/ijerph20054436 -
Microbial Pathogenesis Sep 2021Toxoplasmosis is one of the most common parasitic infections in humans, which is caused by Toxoplasma gondii. It is usually asymptomatic but primary infection in a... (Meta-Analysis)
Meta-Analysis
Toxoplasmosis is one of the most common parasitic infections in humans, which is caused by Toxoplasma gondii. It is usually asymptomatic but primary infection in a pregnant woman can cause severe consequences in the fetus such as miscarriage. This study aimed to estimate the global prevalence of T. gondii infection in women with spontaneous abortion. It also evaluates the possible relationship between recent Toxoplasma infection and miscarriage. Five electronic databases were reviewed. We used the random effects model and 95% confidence intervals(CI) to determine the overall prevalence and odds ratio (OR). Heterogeneity was calculated using Cochran's Q test and I statistic. The included studies were divided into three sub-groups based on antibody class against T. gondii and the existence of parasite DNA. Based on PCR, the pooled random-effects estimates that the prevalence of T. gondii infection in women with abortion was 10% (95% CI 7-14%). The pooled random effect favored a statistically significant increased risk of latent Toxoplasma infection [OR = 1.84; 95% CI: 1.41-2.40, P < 0.001] and recent infection [OR = 3.72; 95% CI: 2.21-6.26, P < 0.001] in women with spontaneous abortions. In recent infections, significant pooled ORs of positive association were observed in women with miscarriage [OR = 4.2; 95% CI: 2.04-8.85; χ2 = 17.2; I = 42.0%, P = 0.07]. This study demonstrates that recent T. gondii infection is associated with an elevated risk of spontaneous abortion. Further studies concerning all risk factors related to toxoplasmosis, and undertaking confirmatory tests at the time of abortion should be performed to investigate the impact of T. gondii infection and spontaneous abortion.
Topics: Abortion, Spontaneous; Antibodies, Protozoan; Female; Humans; Immunoglobulin M; Pregnancy; Risk Factors; Seroepidemiologic Studies; Toxoplasma; Toxoplasmosis
PubMed: 34186117
DOI: 10.1016/j.micpath.2021.105070 -
Malaria Journal Oct 2011During pregnancy, malaria infection with Plasmodium falciparum or Plasmodium vivax is related to adverse maternal health and poor birth outcomes. Diagnosis of malaria,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
During pregnancy, malaria infection with Plasmodium falciparum or Plasmodium vivax is related to adverse maternal health and poor birth outcomes. Diagnosis of malaria, during pregnancy, is complicated by the absence or low parasite densities in peripheral blood. Diagnostic methods, other than microscopy, are needed for detection of placental malaria. Therefore, the diagnostic accuracy of rapid diagnostic tests (RDTs), detecting antigen, and molecular techniques (PCR), detecting DNA, for the diagnosis of Plasmodium infections in pregnancy was systematically reviewed.
METHODS
MEDLINE, EMBASE and Web of Science were searched for studies assessing the diagnostic accuracy of RDTs, PCR, microscopy of peripheral and placental blood and placental histology for the detection of malaria infection (all species) in pregnant women.
RESULTS
The results of 49 studies were analysed in metandi (Stata), of which the majority described P. falciparum infections. Although both placental and peripheral blood microscopy cannot reliably replace histology as a reference standard for placental P. falciparum infection, many studies compared RDTs and PCR to these tests. The proportion of microscopy positives in placental blood (sensitivity) detected by peripheral blood microscopy, RDTs and PCR are respectively 72% [95% CI 62-80], 81% [95% CI 55-93] and 94% [95% CI 86-98]. The proportion of placental blood microscopy negative women that were negative in peripheral blood microscopy, RDTs and PCR (specificity) are 98% [95% CI 95-99], 94% [95% CI 76-99] and 77% [95% CI 71-82]. Based on the current data, it was not possible to determine if the false positives in RDTs and PCR are caused by sequestered parasites in the placenta that are not detected by placental microscopy.
CONCLUSION
The findings suggest that RDTs and PCR may have good performance characteristics to serve as alternatives for the diagnosis of malaria in pregnancy, besides any other limitations and practical considerations concerning the use of these tests. Nevertheless, more studies with placental histology as reference test are urgently required to reliably determine the accuracy of RDTs and PCR for the diagnosis of placental malaria. P. vivax-infections have been neglected in diagnostic test accuracy studies of malaria in pregnancy.
Topics: Antigens, Protozoan; DNA, Protozoan; Diagnostic Tests, Routine; Female; Histocytochemistry; Humans; Malaria, Falciparum; Malaria, Vivax; Microscopy; Parasitemia; Placenta; Plasmodium falciparum; Plasmodium vivax; Polymerase Chain Reaction; Pregnancy; Pregnancy Complications, Infectious
PubMed: 22035448
DOI: 10.1186/1475-2875-10-321 -
Journal of Water and Health Mar 2015Global climate change is expected to impact drinking water quality through multiple weather-related phenomena. We conducted a systematic review and meta-analysis of the... (Meta-Analysis)
Meta-Analysis Review
Global climate change is expected to impact drinking water quality through multiple weather-related phenomena. We conducted a systematic review and meta-analysis of the relationship between various weather-related variables and the occurrence and concentration of Cryptosporidium and Giardia in fresh surface waters. We implemented a comprehensive search in four databases, screened 1,228 unique citations for relevance, extracted data from 107 relevant articles, and conducted random-effects meta-analysis on 16 key relationships. The average odds of identifying Cryptosporidium oocysts and Giardia cysts in fresh surface waters was 2.61 (95% CI = 1.63-4.21; I² = 16%) and 2.87 (95% CI = 1.76-4.67; I² = 0%) times higher, respectively, during and after extreme weather events compared to baseline conditions. Similarly, the average concentration of Cryptosporidium and Giardia identified under these conditions was also higher, by approximately 4.38 oocysts/100 L (95% CI = 2.01-9.54; I(2) = 0%) and 2.68 cysts/100 L (95% CI = 1.08-6.55; I² = 48%). Correlation relationships between other weather-related parameters and the density of these pathogens were frequently heterogeneous and indicated low to moderate effects. Meta-regression analyses identified different study-level factors that influenced the variability in these relationships. The results can be used as direct inputs for quantitative microbial risk assessment. Future research is warranted to investigate these effects and potential mitigation strategies in different settings and contexts.
Topics: Climate Change; Cryptosporidium; Environmental Monitoring; Fresh Water; Giardia; Oocysts; Water Pollutants; Weather
PubMed: 25719461
DOI: 10.2166/wh.2014.079 -
Parasitology International Feb 2020The link between cryptosporidiosis and cancer has been suggested by some epidemiological studies. This systematic review and meta-analysis was conducted to further... (Meta-Analysis)
Meta-Analysis
The link between cryptosporidiosis and cancer has been suggested by some epidemiological studies. This systematic review and meta-analysis was conducted to further understand this relationship. In the current study, six electronic databases were reviewed for Cryptosporidium infection in cancer patients. We used random effects model and 95% confidence intervals (CI) to determine the overall odds ratio (OR). Heterogeneity was calculated with Cochran's Q test and Istatistic. In total, 19 studies involving 3562 individuals with case-control (nine) and cross-sectional (ten) designs were included in our project. The pooled overall random effect favored a statistically significant increased risk of Cryptosporidium infection in cancer patients compared with non-cancer individuals [OR = 3.3; 95% CI: 2.18-4.98]. The overall heterogeneity was medium (χ = 25.77; I = 30.2%, P = .11). The pooled ORs in case-control and cross-sectional studies were [OR = 5.60; 95% CI: 3.43-9.13; χ = 5.51; I = 0.00%, P = .70] and [OR = 2.08; 95% CI: 1.18-3.67; χ = 13.69; I = 34.3, P = .13], respectively. T-value and P-value were 0.54 and 0.57 based on the results of Harbord's modified's regression test. In summary, this meta-analysis demonstrates that Cryptosporidium infection is associated with cancer. Also, it found that study design and year of publication are the specific sources of heterogeneity. Further studies should be carried out to investigate the impact of Cryptosporidium infection in the onset or development of cancer in the future.
Topics: Animals; Case-Control Studies; Cross-Sectional Studies; Cryptosporidiosis; Cryptosporidium; Humans; Neoplasms; Odds Ratio; Risk Factors
PubMed: 31472267
DOI: 10.1016/j.parint.2019.101979 -
The Lancet. HIV Apr 2017Worldwide, 30% of the world's population have antibodies to the intracellular protozoan parasite Toxoplasma gondii and about 36·7 million people are infected with HIV,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Worldwide, 30% of the world's population have antibodies to the intracellular protozoan parasite Toxoplasma gondii and about 36·7 million people are infected with HIV, but little is known about the prevalence of co-infection with T gondii and HIV. We aimed to characterise the epidemiology and burden of T gondii co-infection in people with HIV infection.
METHODS
In this systematic review and meta-analysis, we searched PubMed, Embase, Google Scholar, ScienceDirect, Chinese Web of Knowledge, Wanfang, and Chongqing VIP databases for studies reporting T gondii infection in HIV-infected people from inception to Feb 29, 2016. Studies were included if they investigated people with HIV infection and presented data that allowed us to establish the prevalence of T gondii infection. We excluded reviews, repeated studies, or animal studies, as well as studies that provided the final results without raw data, had a sample size less than 30 people, had unclear diagnostic methods of T gondii infection, or that included populations with increased risk of T gondii infection. We extracted the numbers of patients with HIV infection and T gondii co-infection from the identified studies. We estimated pooled prevalence of T gondii infection in HIV-infected people by a random-effects model, and evaluated its overall infection burden worldwide.
FINDINGS
Our search identified 7843 records and after removal of duplicates and initial screening, we reviewed 312 studies in full. Of these articles, 238 were excluded, leaving 74 studies that included 25 989 HIV-infected people from 34 countries. Of these people, 7326 had T gondii co-infection and we estimated the pooled worldwide prevalence of T gondii infection to be 35·8% (95% CI 30·8-40·7). 2353 of 8837 of people in Asia and the Pacific had co-infection with T gondii and HIV (prevalence 25·1%, 95% CI 19·0-31·2), and prevalence was low in this region compared with that in sub-Saharan Africa (44·9%, 32·3-57·5, 2129/5686; odds ratio [OR] 0·61), Latin America and the Caribbean (49·1%, 27·9-70·4, 510/980; OR 0·33), and North Africa and the Middle East (60·7%, 24·1-97·3, 245/439; OR 0·29). 1561 of 3780 people in low-income countries had co-infection (54·7%, 95% CI 35·8-73·5), which was higher than in middle-income countries (34·2%, 27·4-40·9, 3632/11 540; OR 1·53) and high-income countries (26·3%, 20·4-32·2, 2133/10 669; OR 2·82). Worldwide, we calculated that there were roughly 13 138 600 (95% CI 11 303 600-14 936 900) cases of T gondii co-infection in HIV-infected people, with 87·1% in sub-Saharan Africa (11 449 500 cases, 95% CI 8 236 500-14 662 500).
INTERPRETATION
Our findings suggest that people with HIV infection have a very high burden of T gondii infection, especially in sub-Saharan Africa, and emphasise the importance of routine surveillance for T gondii infection in all HIV-infected people.
FUNDING
National Natural Science Foundation and the Special Fund for Agro-scientific Research in the Public Interest in China.
Topics: Adolescent; Africa South of the Sahara; Caribbean Region; Coinfection; Cost of Illness; Female; HIV Infections; Humans; Latin America; Prevalence; Toxoplasma; Toxoplasmosis
PubMed: 28159548
DOI: 10.1016/S2352-3018(17)30005-X -
Parasites & Vectors Nov 2012Toxoplasmosis is a disease caused by Toxoplasma gondii and at least one-third of the world's population has detectable T. gondii antibodies. The seroprevalence of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Toxoplasmosis is a disease caused by Toxoplasma gondii and at least one-third of the world's population has detectable T. gondii antibodies. The seroprevalence of T.gondii ranges from 15% to 50% among the Mexican general population. The aim of this work was to determine the mean prevalence and weighted mean prevalence of T. gondii infection, and to evaluate the epidemiological transition of infection in Mexico.
METHODS
Pub Med, Lilacs, Medline, Latindex, Google Scholar data bases were searched to retrieve reports from 1951 up to 2012 regarding prevalence data, diagnostic tests and risk factors of infection among the adult population. Data collection and criteria eligibility was established in order to determine the crude prevalence (proportion of positive cases) of each study, together with weighted population prevalence according to individual research group categories to limit the bias that may impose the heterogeneous nature of the reports. A Forest Plot chart and linear regression analysis were performed by plotting the prevalence of infection reported from each study over a period of sixty years.
RESULTS
A total of 132 studies were collected from 41 publications that included 70,123 individuals. The average mean prevalence was 27.97%, and weighted mean prevalence was 19.27%. Comparisons among different risk groups showed that the weighted prevalence was higher in women with miscarriages (36.03%), immunocompromised patients (28.54%), mentally-ill patients (38.52%) and other risk groups (35.13%). Toxoplasma infection among the Mexican population showed a downward trend of 0.1%/year over a period of sixty years that represents a 5.8% reduction in prevalence.
CONCLUSIONS
This analysis showed a downward trend of infection; however, there are individuals at high risk for infection such as immunocompromised patients, mentally-ill patients and pregnant women. Further research is required to provide better prevention strategies, effective diagnostic testing and medical management of patients. Educational efforts are required to avoid the transmission of infection in populations that cannot be controlled by drugs alone.
Topics: Abortion, Spontaneous; Antibodies, Protozoan; Databases, Factual; Female; Humans; Immunocompromised Host; Male; Mental Disorders; Mexico; Pregnancy; Pregnancy Complications, Parasitic; Prevalence; Risk Factors; Seroepidemiologic Studies; Toxoplasma; Toxoplasmosis
PubMed: 23181616
DOI: 10.1186/1756-3305-5-271