Department GF Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy.
PLoS Negl Trop Dis. 2012;6(8):e1775. doi: 10.1371/journal.pntd.0001775. Epub 2012 Aug 14.
Human toxocariasis is a zoonotic infection caused by the larval stages of Toxocara canis (T. canis) and less frequently Toxocara cati (T. cati). A relationship between toxocariasis and epilepsy has been hypothesized. We conducted a systematic review and a meta-analysis of available data to evaluate the strength of association between epilepsy and Toxocara spp. seropositivity and to propose some guidelines for future surveys.
Electronic databases, the database from the Institute of Neuroepidemiology and Tropical Neurology of the University of Limoges (http://www-ient.unilim.fr/) and the reference lists of all relevant papers and books were screened up to October 2011.
We performed a systematic review of literature on toxocariasis (the exposure) and epilepsy (the outcome). Two authors independently assessed eligibility and study quality and extracted data. A common odds ratio (OR) was estimated using a random-effects meta-analysis model of aggregated published data.
Seven case-control studies met the inclusion criteria, for a total of 1867 participants (850 cases and 1017 controls). The percentage of seropositivity (presence of anti-Toxocara spp. antibodies) was higher among people with epilepsy (PWE) in all the included studies even if the association between epilepsy and Toxocara spp. seropositivity was statistically significant in only 4 studies, with crude ORs ranging 2.04-2.85. Another study bordered statistical significance, while in 2 of the included studies no significant association was found. A significant (p < 0.001) common OR of 1.92 [95% confidence interval (CI) 1.50-2.44] was estimated. Similar results were found when meta-analysis was restricted to the studies considering an exclusively juvenile population and to surveys using Western Blot as confirmatory or diagnostic serological assay.
Our results support the existence of a positive association between Toxocara spp. seropositivity and epilepsy. Further studies, possibly including incident cases, should be performed to better investigate the relationship between toxocariasis and epilepsy.
人类弓蛔虫病是一种由犬弓蛔虫（T. canis）和较少见的猫弓蛔虫（T. cati）幼虫引起的人畜共患感染。人们假设弓蛔虫病和癫痫之间存在关联。我们对现有数据进行了系统回顾和荟萃分析，以评估癫痫与弓蛔虫属 spp. 血清阳性之间的关联强度，并为未来的调查提出一些指导原则。
电子数据库、利摩日大学神经流行病学和热带神经病学研究所的数据库（http://www-ient.unilim.fr/）以及所有相关论文和书籍的参考文献列表均进行了筛选，截至 2011 年 10 月。
我们对弓蛔虫病（暴露）和癫痫（结局）的文献进行了系统回顾。两名作者独立评估了合格性和研究质量，并提取了数据。使用聚合发表数据的随机效应荟萃分析模型，估算了共同的比值比（OR）。
符合纳入标准的病例对照研究共有 7 项，共纳入 1867 名参与者（850 例病例和 1017 例对照）。在所有纳入的研究中，患有癫痫的人（PWE）的血清阳性率（存在抗弓蛔虫属 spp. 抗体）更高，尽管只有 4 项研究表明癫痫与弓蛔虫属 spp. 血清阳性之间存在统计学意义，其粗比值比范围为 2.04-2.85。另一项研究接近统计学意义，而在纳入的 2 项研究中未发现显著相关性。估计出一个显著的（p < 0.001）共同 OR 为 1.92[95%置信区间（CI）1.50-2.44]。当荟萃分析仅限于考虑纯青少年人群的研究和使用 Western Blot 作为确认或诊断血清学检测的研究时，得到了相似的结果。
我们的结果支持弓蛔虫属 spp. 血清阳性与癫痫之间存在正相关。应进一步开展研究，包括可能发生的病例，以更好地研究弓蛔虫病和癫痫之间的关系。
