Department of Paraclinical Studies, College of Veterinary Medicine and Animal Sciences, University of Gondar, Gondar, Ethiopia.
Department of Veterinary Epidemiology and Public Health, College of Veterinary Medicine and Animal Sciences, University of Gondar, Gondar, Ethiopia.
PLoS Negl Trop Dis. 2020 Dec 15;14(12):e0008944. doi: 10.1371/journal.pntd.0008944. eCollection 2020 Dec.
Toxoplasma gondii is an obligate intracellular and neurotropic apicomplexan protozoan parasite infecting almost all warm-blooded vertebrates including humans. To date in Ethiopia, no systematic study has been investigated on the overall effects of potential risk factors associated with seropositivity for Toxoplasma gondii among pregnant women and HIV infected individuals. We intended to determine the potential risk factors (PRFs) associated with seropositivity for Toxoplasma gondii from published data among pregnant women and HIV infected individuals of Ethiopia.
An systematic review of the previous reports was made. We searched PubMed, Science Direct, African Journals Online, and Google Scholar for studies with no restriction on the year of publication. All references were screened independently in duplicate and were included if they presented data on at least two risk factors. Meta-analysis using the random or fixed-effects model was made to calculate the overall effects for each exposure.
Of the 216 records identified, twenty-four reports met our eligibility criteria, with a total of 6003 individuals (4356 pregnant women and 1647 HIV infected individuals). The pooled prevalences of anti-Toxoplasma gondii antibodies were found at 72.5% (95% CI: 58.7% - 83.1%) in pregnant women and 85.7% (95% CI: 76.3% - 91.8%) in HIV infected individuals. A significant overall effect of anti-Toxoplasma gondii seropositivity among pregnant women (p < 0.05) was witnessed with age, abortion history, contact with cats, cat ownership, having knowledge about toxoplasmosis, being a housewife and having unsafe water source. Age, cat ownership, and raw meat consumption were also shown a significant effect (p < 0.05) to anti-Toxoplasma gondii seropositivity among HIV infected individuals.
This review showed gaps and drawbacks in the earlier studies that are useful to keep in mind to design accurate investigations in the future. The pooled prevalence of anti-Toxoplasma gondii antibodies was found to be higher among pregnant women and HIV infected individuals. This suggests that thousands of immunocompromised individuals (pregnant women and HIV infected patients) are at risk of toxoplasmosis due to the sociocultural and living standards of the communities of Ethiopia. Appropriate preventive measures are needed to reduce the exposure to Toxoplasma gondii infection. Further studies to investigate important risk factors are recommended to support the development of more cost-effective preventive strategies.
刚地弓形虫是一种专性细胞内和嗜神经性顶复门原虫寄生虫，感染几乎所有温血脊椎动物，包括人类。迄今为止，在埃塞俄比亚，尚未对与孕妇和 HIV 感染者的弓形虫血清阳性相关的潜在危险因素进行系统研究。我们旨在从已发表的数据中确定与埃塞俄比亚孕妇和 HIV 感染者的弓形虫血清阳性相关的潜在危险因素（PRFs）。
对以前的报告进行了系统综述。我们在 PubMed、Science Direct、African Journals Online 和 Google Scholar 上进行了搜索，对出版物年份没有限制。所有参考文献均独立进行了两次筛选，如果至少有两个危险因素，则将其纳入研究。使用随机或固定效应模型进行荟萃分析，以计算每个暴露因素的总体效应。
在 216 条记录中，有 24 份报告符合我们的入选标准，共有 6003 人（4356 名孕妇和 1647 名 HIV 感染者）。孕妇的抗弓形虫抗体阳性率为 72.5%（95%CI：58.7%-83.1%），HIV 感染者的阳性率为 85.7%（95%CI：76.3%-91.8%）。孕妇抗弓形虫血清阳性具有显著的总体效应（p<0.05），与年龄、流产史、接触猫、养猫、对弓形虫病的认识、家庭主妇和不安全的水源有关。年龄、养猫和生肉食用也对 HIV 感染者的抗弓形虫血清阳性有显著影响（p<0.05）。
本综述显示，早期研究存在差距和缺陷，这有助于在未来设计更准确的调查时牢记这些问题。孕妇和 HIV 感染者的抗弓形虫抗体阳性率较高。这表明，由于埃塞俄比亚社区的社会文化和生活水平，成千上万的免疫功能低下者（孕妇和 HIV 感染者）面临弓形虫病的风险。需要采取适当的预防措施来减少感染弓形虫的风险。建议进一步研究重要的危险因素，以支持制定更具成本效益的预防策略。
