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and projects and theses of Iranian medical universities, were systematically searched from 1997 to 2013 (published or unpublished data).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.
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 In the present study data collection (published and unpublished papers, abstracts of proceedings of national parasitology congresses and dissertations) was systematically undertaken on electronic databases including PubMed,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.
A cross-sectional survey was undertaken to study the prevalence and intensity of infection with Toxocara cati in 100 stray cats, from April to October 2004 in urban areas of Sari, northern Iran. A total of 44 cats (44%) were found to be infected with T. cati. There was a significant difference in the prevalence of infection relative to host age and weight (P = 0.000). There was also a significant difference in the intensity of infection relative to body weight and urban sites (P < 0.05). No significant difference was found between the prevalence of infection relative to host gender, urban sites and season (P>0.05), nor in the intensity of infection between host gender, age and season (P>0.05). The intensity of infection ranged from 1 to 32 worms per cat, with a mean of 7.30 +/- 6.82.
This cross-sectional study was carried out on 1210 randomly selected schoolchildren, attending sixteen primary and secondary schools, during the period between November 2005 and June 2006. Parents who accepted to include their children were requested to be present at sampling time and to fill in a simple questionnaire with personal and epidemiological data. Three milliliter of venous blood were taken by vein puncture under sterile conditions from each subject for detection and titration of antibodies to T. canis and eosinophil counts. Total IgG anti-Toxocara antibodies was evaluated by T. canis IgG ELISA kit. According to the manufacture recommendations, an index positivity >11 U was considered positive. Of the 1210 serum specimens tested, an overall seroprevalence for Toxocara antibodies of 25% was obtained. There was no association between positive seroprevalence and age (p = 0.34). Boys and girls differed significantly with regard to Toxocra titre (p = 0.003). Eosinophilia in peripheral blood (> or = 5%) was detected in 24.5% (297/1210) of the population studied, 97/297 (32.8%) of whom were seropositive for toxocariasis. The findings of this study confirmed that infection with Toxocara is quite high and widespread in children in Northern Iran. Therefore, health promotion efforts must be directed at increasing the awareness of the population about the potential zoonotic hazards associated with the disease and how to minimize them.
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