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Although toxoplasmosis in immunocompetent individuals is generally asymptomatic, in immunocompromised patients (HIV/AIDS, cancer, and transplant patients), it can lead to serious pathological effects. This study included a systematic review and meta-analysis to comprehensively assess the seroprevalence rate of Toxoplasma infection in immunocompromised patients in Iran. Electronic English and Persian databases (PubMed, Google Scholar, ScienceDirect, Scopus, Magiran, Scientific Information Database [SID], IranMedex, and IranDoc), parasitology congresses, and projects and theses of Iranian medical universities, were systematically searched from 1997 to 2013 (published or unpublished data). In this paper, several studies that used serological methods for diagnosis of toxoplasmosis were selected. Analysis of seroprevalence estimates was pooled using a random-effects meta-analysis. Twenty-two studies, comprising 2,805 individuals, were included in the meta-analysis. Overall seroprevalence rate of Toxoplasma infection in Iranian immunocompromised patients was 50.01% (95% confidence interval, 43.85 to 56.17); however, there was significant heterogeneity among study groups. The results showed that seroprevalence rate of toxoplasmosis among transplant recipients, HIV/AIDS, and cancer patients in Iran was 55.1%, 50.05%, and 45.06%, respectively. In addition, IgM seroprevalence rate was estimated to be 4.85% (95% confidence interval, 2.22 to 8.41). This systematic review and meta-analysis identified a high seroprevalence rate of Toxoplasma infection among immunocompromised patients (50%).Consideration of management , design and provision of appropriate control measures of toxoplasmosis is highly recommended.

Toxoplasmosis, a cosmopolitan parasitic infection caused by Toxoplasma gondii, is frequently found in meat-producing animals and human beings. This review and meta-analysis study was performed to evaluate the overall prevalence of T. gondii infection among sheep and goats in Iran. Data were systematically collected from 1977 to 2012 in Iran on the following electronic databases: PubMed, Google Scholar, Science Direct, Scopus, Web of Science, Magiran, Irandoc, IranMedex, and Scientific Information Database (SID). Additionally, abstracts of national scientific congresses and dissertations were included. A total of 34 articles in field of sheep and 18 articles about goat toxoplasmosis, totalizing to the examination of 14,372 sheep and 3,120 goats, reporting prevalence of toxoplasmosis from different regions of Iran fulfilled our eligibility criteria. The overall prevalence rate of toxoplasmosis in Iran was estimated to be 31% (95% confidence interval (CI) = 0.259825 to 0.352382) in sheep and 27% (95% CI = 0.140097 to 0.424782) in goats, respectively. There was no significant difference in infection rate between males and females among sheep (odds ratio (OR) = 1.002, 95% CI = 0.59 to 1.696) and goats (OR = 1.027, 95% CI = 0.685 to 1.541). Analysis revealed that infection rate in sheep over than 1 year old was 2.4 times more than that in less than 1 year old (OR = 2.396, 95% CI = 1.050 to 5.467). This systematic review and meta-analysis study revealed that infection is widespread in Iran. Further studies are required to improve strategies for controlling infection among flocks and consequently in human population.

Toxoplasma gondii is a cosmopolitan zoonotic intracellular coccidian of the phylum Apicomplexa infecting warm-blooded animals and human beings. This protozoan causes a significant public health problem in humans and imposes considerable economic losses and damages to husbandry industries. The final host, cats, accounts for all of these significant burdens. Hence the present study was designed to analyse and review the overall prevalence rate of T. gondii infection in cats in Iran for the first time. In the present study data collection (published and unpublished papers, abstracts of proceedings of national parasitology congresses and dissertations) was systematically undertaken on electronic databases including PubMed, Google Scholar, Ebsco, Science Direct, Scopus, Magiran, Irandoc, IranMedex and Scientific Information Database. A total of 21 studies from 1975 to 2013 reporting prevalence of Toxoplasma infection in cats from different areas in Iran met the eligibility criteria. The pooled proportion of toxoplasmosis using the random-effect model amongst cats was estimated at 33.6% (95% confidence interval [CI] 22.05–46.41). The prevalence rate of cat toxoplasmosis in various regions of Iran ranged from 1.2% to 89.2%. Firstly, this study establishes a crude prevalence rate of T. gondii infection in cats. Secondly, it discusses the role of significant risk factors including sex, age and being either household or stray cats, in the epidemiology of the disease. Furthermore, the current study determines gaps and drawbacks in the prior studies that are useful to keep in mind to assist in designing more accurate investigations in future.

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BackgroundToxoplasmosis is caused by an intracellular obligatory parasite, Toxoplasma gondii, and it has global distribution. The purposes of this systematic review and meta-analysis were to evaluate the seroprevalence of toxoplasmosis in Iranian pregnant women, and girls and women of childbearing age, and identify potentially preventable risk factors.MethodsBetween November 2014 and February 2017, nine electronic databases that reported data on the T. gondii seroprevalence in Iranian women were searched. Our search resulted in 83 reports published from 1994 to 2017.ResultsThe results showed that the pooled estimation for the prevalence of T. gondii using a random-effect model was 43% (95% confidence interval (CI) = 38–48%) in pregnant women and 33% (95% CI = 23–43%) in girls and the childbearing age groups. There was a significant association between the T. gondii seroprevalence with age and the gestational age of conception in pregnant women and those who had contact with cats in both groups.ConclusionsThis is the first comprehensive systematic review of T. gondii infection seroprevalence in Iranian women, which showed a high prevalence of Toxoplasma infection. Around 57% of pregnant women and 67% of girls and the childbearing age groups were seronegative and thus were susceptible to infection and should be monitored.Electronic supplementary materialThe online version of this article (doi:10.1186/s41182-017-0048-7) contains supplementary material, which is available to authorized users.

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