Ngoungou Edgard B, Bhalla Devender, Nzoghe Amandine, Dardé Marie-Laure, Preux Pierre-Marie
INSERM, UMR1094, Neuroépidémiologie Tropicale, Limoges, France; Université de Limoges, UMR 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France; Département d'Epidémiologie-Biostatistiques et Informatique Médicale (DEBIM/EA NEMIT), Faculté de Médecine, Université des Sciences de la Santé, Libreville, Gabon.
INSERM, UMR1094, Neuroépidémiologie Tropicale, Limoges, France; Université de Limoges, UMR 1094, Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France.
PLoS Negl Trop Dis. 2015 Feb 19;9(2):e0003525. doi: 10.1371/journal.pntd.0003525. eCollection 2015 Feb.
Toxoplasmosis 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.
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 (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%.
Six 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.
Despite 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.
弓形虫病是由刚地弓形虫引起的一种重要的、广泛传播的寄生虫感染。免疫功能正常患者的慢性感染通常被认为是无症状的，现在怀疑它是包括癫痫在内的各种神经系统疾病的一个危险因素。我们旨在对现有文献进行系统综述和荟萃分析，以评估弓形虫病导致癫痫的风险。
对多个数据库和期刊进行系统的文献检索，以识别不限日期发表的英文或法文研究，这些研究关注弓形虫病（作为暴露因素）和癫痫（作为疾病），并符合某些其他纳入标准。检索基于英文和法文的关键词及合适的组合。使用固定效应模型和随机效应模型来确定比值比，统计学显著性设定为5.0%。
共识别出6项研究，估计共有2888名受试者，其中1280人患有癫痫（477人弓形虫病检测呈阳性），1608人未患癫痫（503人弓形虫病检测呈阳性）。随机效应模型计算得出的共同比值比为2.25（95%置信区间1.27 - 3.9），p = 0.005。
尽管研究数量有限且缺乏高质量数据，但弓形虫病仍应继续被视为癫痫的一个危险因素。需要更多更好的研究来确定这种寄生虫对癫痫发生的实际影响。
