Background: Toxoplasmosis is becoming a global health hazard as it infects 30–50% of the world human population. Clinically, the life-long presence of the parasite in tissues of a majority of infected individuals is usually considered asymptomatic. However, a number of studies show that this ‘asymptomatic infection’ may also lead to development of other human pathologies. Aims of the Study: The purpose of the study was to collect available geoepidemiological data on seroprevalence of toxoplasmosis and search for its relationship with mortality and disability rates in different countries. Methods and Findings: Prevalence data published between 1995–2008 for women in child-bearing age were collected for 88 countries (29 European). The association between prevalence of toxoplasmosis and specific disease burden estimated with age-standardized Disability Adjusted Life Year (DALY) or with mortality, was calculated using General Linear Method with Gross Domestic Product per capita (GDP), geolatitude and humidity as covariates, and also using nonparametric partial Kendall correlation test with GDP as a covariate. The prevalence of toxoplasmosis correlated with specific disease burden in particular countries explaining 23% of variability in disease burden in Europe. The analyses revealed that for example, DALY of 23 of 128 analyzed diseases and disease categories on the WHO list showed correlations (18 positive, 5 negative) with prevalence of toxoplasmosis and another 12 diseases showed positive trends (p,0.1). For several obtained significant correlations between the seroprevalence of toxoplasmosis and specific diseases/clinical entities, possible pathophysiological, biochemical and molecular explanations are presented. Conclusions: The seroprevalence of toxoplasmosis correlated with various disease burden. Statistical associations does not necessarily mean causality. The precautionary principle suggests however that possible role of toxoplasmosis as a triggering factor responsible for development of several clinical entities deserves much more attention and financial support both in everyday medical practice and future clinical research.

/pdf/toxoplasmosis-a-global-threat-correlation-of-latent-51kbfh1eag.pdf

Toxoplasmosis – A Global Threat. Correlation of Latent Toxoplasmosis with Specific Disease Burden in a Set of 88 Countries

The failure to find genes of major effect in schizophrenia has refocused attention on nongenetic, including infectious factors. In a previous study, antibodies to Toxoplasma gondii were found to be elevated in 23 studies of schizophrenia (OR 2.73; 95% CI 2.10–3.60). The current study replicates this finding with 15 additional studies (OR 2.71; 95% CI 1.93–3.80) and compares this with other identified schizophrenia risk factors. The highest risk factors are having an affected mother (relative risks [RR] 9.31; 95% CI 7.24–11.96), father (RR 7.20; 95% CI 5.10–10.16), or sibling (RR 6.99; 95% CI 5.38–9.08) or being the offspring of immigrants from selected countries (RR 4.5; 95% CI 1.5–13.1). Intermediate risk factors, in addition to infection with T. gondii, include being an immigrant from and to selected countries (RR 2.7; 95% CI 2.3–3.2), being born in (RR 2.24; 95% CI 1.92–2.61) or raised in (RR 2.75; 95% CI 2.31–3.28) an urban area, cannabis use (OR 2.10–2.93; 95% CI 1.08–6.13), having minor physical anomalies (OR 2.23; 95% CI 1.42–3.58), or having a father 55 or older (OR 2.21–5.92; 95% CI 1.46-17.02). Low-risk factors include a history of traumatic brain injury (OR 1.65; 95% CI 1.17–2.32), sex abuse in childhood (OR 1.46; 95% CI 0.84–2.52), obstetrical complications (OR 1.29–1.38; 95% CI 1.00–1.84), having a father 45 or older (OR 1.21–1.66; 95% CI 1.09–2.01), specific genetic polymorphisms (OR 1.09–1.24; 95% CI 1.06–1.45), birth seasonality (OR 1.07–1.95; 95% CI 1.05–2.91), maternal exposure to influenza (RR 1.05; 95% CI 0.98–1.12), or prenatal stress (RR 0.98–1.00; 95% CI 0.85–1.16).

/pdf/toxoplasma-gondii-and-other-risk-factors-for-schizophrenia-ce51z5144i.pdf

Toxoplasma gondii and Other Risk Factors for Schizophrenia: An Update

Objective
To perform a meta-analysis on studies reporting prevalence of Toxoplasma gondii (T. gondii) infection in any psychiatric disorder compared with healthy controls. Our secondary objective was to analyze factors possibly moderating heterogeneity.

Method
A systematic search was performed to identify studies into T. gondii infection for all major psychiatric disorders versus healthy controls. Methodological quality, publication bias, and possible moderators were assessed.

Results
A total of 2866 citations were retrieved and 50 studies finally included. Significant odds ratios (ORs) with IgG antibodies were found in schizophrenia (OR 1.81, P < 0.00001), bipolar disorder (OR 1.52, P = 0.02), obsessive–compulsive disorder (OR 3.4, P < 0.001), and addiction (OR 1.91, P < 0.00001), but not for major depression (OR 1.21, P = 0.28). Exploration of the association between T. gondii and schizophrenia yielded a significant effect of seropositivity before onset and serointensity, but not IgM antibodies or gender. The amplitude of the OR was influenced by region and general seroprevalence. Moderators together accounted for 56% of the observed variance in study effects. After controlling for publication bias, the adjusted OR (1.43) in schizophrenia remained significant.

Conclusion
These findings suggest that T. gondii infection is associated with several psychiatric disorders and that in schizophrenia reactivation of latent T. gondii infection may occur.

Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta‐analysis

Toxoplasma gondii infections during pregnancy can result in abortion or congenital defects. Prevalence and risk factors of toxoplasmosis in women of child-bearing age in Ethiopia are unknown. The current study was conducted with the objectives of estimating the seroprevalence and potential risk factors in acquiring T. gondii infection by women of child-bearing age in Central Ethiopia. A cross-sectional study was conducted from March 2011 to September 2011. Sera of 425 women were analyzed by indirect enzyme linked immunosorbent assay (ELISA). A questionnaire survey was administered for all study participants to gather information on risk factors. The study revealed that anti- T. gondii IgG antibodies were detected in 81.4% of the samples of which 78.4% were positive for only IgG and 3.06% positive for both IgG and IgM antibodies. Seroprevalence of IgM antibodies to T. gondii (4.0%, 95% CI: 2.14, 5.86) was suggestive of recent infections. Of the 213 pregnant women 9 (4.2 %) were IgM reactive. Out of 17 potential risk factors investigated, univariate logistic regression showed significant association of T. gondii infection with study area, age, pregnancy status, raw vegetable consumption, source of water, presence of cats at home, contact with cats, HIV status and precaution during cats’ feces cleaning (P ≤ 0.05). The final logistic regression model revealed that: the probability of acquiring T. gondii infection by women of Debre-Zeit was 4.46 times (95% CI of adjusted odds ratio [aOR]: 1.67, 11.89; P =0.003) higher compared to women of Ambo, pregnant women were twice (95% CI aOR: 1.13, 3.59; P = 0.018) more likely to be seropositive than non-pregnant women and women who consume raw vegetable were at increased risk of infection (aOR = 2.21, 95% CI: 1.03, 4.78; P = 0.043) than women who didn’t consume. The seroprevalence of T. gondii infection in women of child-bearing age in Central Ethiopia is high. Study area, pregnancy and raw vegetable consumption are risk factors to acquire T. gondii infection. Educational program, antenatal screening of pregnant women and further epidemiological studies to uncover the economic and health impact of toxoplasmosis are suggested.

https://biblio.ugent.be/publication/4346142/file/4346196.pdf

Seroepidemiology of Toxoplasma gondii infection in women of child-bearing age in central Ethiopia

"Latent" infection with Toxoplasma gondii: association with trait aggression and impulsivity in healthy adults

Background: Tuberculosis (TB) is a mycobacterial infection mainly affecting the lungs. Early and correct diagnosis of sputum smear negative patients by chest radiography (CXR) is challenging since it depends on reader's ability to detect abnormal findings and to interpret it correctly. Objectives: To evaluate the validity and reliability of CXR the diagnosis of TB among smear negative pulmonary tuberculosis (PTB) Methods: An institutional based cross-sectional study was conducted at seven selected health facilities from October 2011 to September 2012 on 159 adults aged 18 years and above who were newly diagnosed smear negative for PTB patients diagnosed using Chest X-ray (CXR). Morning sputum was collected and cultured from each patient using Lowenstein Jensen media. All the CXRs were revised by senior radiologists in conjunction with the principal investigator.  Results: The mean (SD) age of patients involved in the study was 37.1(16.7), ranging from 18 to 87 years. Of the total 159 smear negative PTB patients, the most common CXR finding was consolidation (40.3%) followed by cavitations (23.9%) and nodular lesions (17.0%). Sputum culture results showed that, 47(29.6%) were culture positive, 103(64.7%) were culture negative and 9(5.6%) were contaminated. About 14% (22/159) of the study subjects were HIV positive. The sensitivity and specificity of CXR findings were 77.1% (37/48) and 36.9% (41/111), respectively. The positive and negative predictive values were 34.6% (37/107) and 78.8% (41/52), respectively. Conclusion: CXR can be used as supportive investigative modality to diagnose smear negative Pulmonary TB in conditions where TB culture is no more feasible.

Evaluating the validity and reliability of chest radiography in the diagnosis of tuberculosis among smear negative pulmonary tuberculosis patients.

BACKGROUND Recent etiological studies for schizophrenia and bipolar disorder have focused on the protozoan Toxoplasma gondii and Herpesvirdae family viruses. OBJECTIVE To determine the magnitude of T. gondii, cytomegalovirus (CMV), herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) infection in individuals with schizophrenia, bipolar disorder and healthy controls by using serologic diagnostic methods. MATERIAL AND METHODS Serologic diagnostic method was used to determine the prevalence and level of antibodies to T gondii, CMV HSV-1 and HSV-2 in individuals with schizophrenia, bipolar disorder, and unaffected controls recruited from Butajira, Ethiopia. The study was conducted from March to May 2009. A total of 495 serum samples were analysed for the presence and level of immunoglobulin G (IgG) to T. gondii, CMV HSV-1, and HSV-2. RESULTS The seroprevalence of T gondii infection was higher in individuals with schizophrenia [adjusted odds ratio = 4.7; 95% CI (1.5, 15.1)] and bipolar disorder [adjusted odds ratio = 3.0; 95% CI (1.1, 8.6)] than in unaffected controls. The level of IgG to CMV was also significantly higher in individuals with schizophrenia and bipoar disorder than in unaffected controls. Younger individuals with schizophrenia (< 25 years old) also had a significantly higher level of IgG to CMV than matched unaffected controls. CONCLUSION This study provides additional evidence that infection with 7T gondii and CMV may be associated with some cases of schizophrenia and bipolar disorder. Additional studies should focus on antibodies to these agents in the sera and CSF of individuals with recent-onset psychosis.

Serum antibodies to Toxoplasma gondii and Herpesvidae family viruses in individuals with schizophrenia and bipolar disorder: a case-control study.

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Evaluating the validity and reliability of chest radiography in the diagnosis of tuberculosis among smear negative pulmonary tuberculosis patients.

Serum antibodies to Toxoplasma gondii and Herpesvidae family viruses in individuals with schizophrenia and bipolar disorder: a case-control study.