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An emerging field of research is starting to examine the association of infectious pathogens with type 2 diabetes mellitus (T2DM). An understudied parasite of interest is Toxoplasma gondii. Globally, very few studies have been conducted to investigate this association. Additionally, very little data exists on the prevalence of T. gondii in the general Australian population. Our group sought to determine the prevalence, association, and risk factors between T. gondii infection and T2DM from a representative Australian human population. Through a cross-sectional, age- and gender-matched case-control study, 150 subjects with T2DM together with 150 control subjects from the Busselton Health Study cohort were investigated. Sera samples were tested for the presence of anti-T. gondii IgG and IgM antibodies using enzyme-linked immunosorbent assays. Survey-derived data were also analyzed to evaluate associated risk factors. The IgG seroprevalence was found to be 62% and 66% for the T2DM and control groups, respectively (OR:0.84; p=0.471). IgM antibodies were detected in 5% of the T2DM patients and in 10% of the controls (OR=0.51; p=0.135). There were no significant differences between male and female IgG seroprevalence rates for both groups (OR:0.88, 0.80; p=0.723). The IgG seropositivity rate increased significantly in T2DM patients aged 45-84 years in comparison to those aged 18-44 years (p<0.05), but this was not observed in the control subjects. No risk factors were associated with T. gondii seropositivity in both groups. The first Australian study of its kind found T. gondii infection in Western Australia to be highly prevalent. The results also showed that there is no serological evidence of an association between T. gondii infection and T2DM in the studied subjects. Australian health authorities should focus on raising awareness of toxoplasma infection and target T. gondii transmission control. Further studies are needed to clarify the role of T. gondii in T2DM.

Objectives: An emerging field of research is examining the association of infectious and environmental pathogens with type 2 diabetes mellitus (T2DM). An understudied pathogen of interest is the protozoan parasite Toxoplasma gondii (T. gondii). The objective of this study was to investigate the possible correlation between T. gondii infection and T2DM. We conducted a systematic review and meta-analysis on the currently available T. gondii seroprevalence data from case-control studies looking at subjects with T2DM in comparison to healthy controls to estimate the risk of T2DM. Methods: Ten electronic databases were searched using specific Medical Subject Headings terms without language or date restrictions. Fixed and random effects models were used to determine odds ratios with statistical significance being set at 5.0%. Results: Ten publications reporting T. gondii seroprevalence from 4072 subjects met the eligibility criteria. Seven of these studies reported a significant association between T. gondii infection and T2DM (p < 0.05). The overall weighted prevalence of T. gondii infection in subjects with T2DM was 47.8% (range 6.4-65.1%) in comparison to 25.9% (range 3.2-59.0%) of healthy controls (p < 0.001). The common odds ratio, calculated using a random effects model, was 2.32 (95% CI 1.66-3.24, p < 0.001). Conclusions: T. gondii infection should continue to be regarded as a possible contributing factor in T2DM disease development. Further studies that include inflammatory biomarker analysis are warranted to determine the specific role of this parasite in the pathogenesis of T2DM.

Introduction: Despite being identified as one of the top neglected parasitic infections, Toxoplasma gondii has received little recognition in Australia with no previously published prevalence data from the general human population. The objectives of the current study were to: determine the prevalence of evidence of exposure to T. gondii infection in an Australian community dwelling population, and: identify associated risk factors. Methods: Sera from 75 males and 75 age-matched females living in Busselton, Western Australia were tested for the presence of anti-T. gondii IgG and IgM antibodies using enzyme-linked immunosorbent assay. Survey derived data were also analysed to evaluate risk factors. Results: IgG and IgM antibodies were detected in 99 (66.0%) and 15 (10.0%) of subjects, respectively. IgG seroprevalence increased from 44.4% (95% confidence interval (95% CI): 18.9-73.3%) in the 18-34 year-old age group to 81.0% (95% CI: 60.0-92.3%) in the 75-84 age group. The observed IgG seroprevalence increased at a rate of 0.8% with each year of age. No risk factors were identified. Conclusions: The first study of its kind in Australia found T. gondii infection to be highly prevalent. Toxoplasma gondii infection has been neglected in Australian notifiable disease programs therefore Australian public health authorities should focus on improving education to raise awareness and commence longitudinal epidemiological data collection to supplement public health models targeting T. gondii transmission control.

Methicillin-resistant Staphylococcus aureus (MRSA)