Human Toxoplasma gondii infection in Nigeria: a systematic review and meta-analysis of data published between 1960 and 2019

Abstract

Background: Over 70% of the worlds' population is infected by Toxoplasma gondii; a pathogen capable of causing cerebral toxoplasmosis in HIV patients and neonatal complications like miscarriage, chorioretinitis, hydrocephalus, cerebral calcification and foetal death in the third trimester of pregnancy. In spite of this, the burden of this zoonotic pathogen is poorly understood in Nigeria. The aim of the present study therefore, is to determine the burden of T. gondii among normal individuals, HIV patients and pregnant women as well as the distribution of the infection across Nigeria. Methods: Using the PRISMA guidelines, we conducted a systematic review and meta-analysis of data retrieved from six electronic databases (AJOL, Google Scholar, PubMed, Scopus, Science Direct and Web of Science). Pooled prevalence (PP) and heterogeneity were determined by the random-effects model and the Cochran's Q-test respectively. The quality of each study and publication bias were assessed by the 9 point Joanna Briggs Institute Critical Appraisal Instrument and the Egger's regression asymmetry test respectively, while the robustness of a pooled estimate was tested by the single study omission analysis. Results: Exactly 5834 of the 16,230 individuals examined for T. gondii infection by 50 studies across 17 Nigerian States were positive for the infection. Overall PP was 32.92% (95% CI: 27.89, 38.37), with a range of 14.41% (95% CI: 5.32, 33.54) to 86.82% (95% CI: 66.13, 95.69) across subgroups. Pooled prevalence was significantly higher (p < 0.001) among pregnant women (40.25%; 95% CI: 33.19, 47.73) and HIV patients (31.68, 95% CI: 20.53, 45.41) than normal individuals (23.32, 95% CI: 17.25, 30.75). T. gondii prevalence declined by over 58% during the 59 years reviewed. Conclusion: Toxoplasma gondii infection is moderately prevalent in Nigeria. Highest prevalence estimates were observed among pregnant women and in the south-south region. For effective control of the disease in Nigeria, a holistic approach involving on-farm, environmental, public health and animal components are suggested.

Global seroprevalence of Toxoplasma gondii infection among patients with mental and neurological disorders: A systematic review and meta‐analysis

“…The present study revealed that the global pooled seroprevalence of chronic T. gondii infection was 38.27% (95% CI: 32.04−44.49) among neuropsychiatric patients and 25.31% (95% CI: 21.53−29.08) in apparently healthy controls with high heterogeneity ( I 2 value of 98.3%). This finding is in line with the global pooled prevalence of T. gondii among HIV patients (35.8%; 95% CI: 30.8−40.7) 76 and the national overall pooled prevalence of human T. gondii infection in Nigeria (32.92% [95% CI: 27.89−38.37]) 77 . Toxoplasma gondii induces a suite of behavioral and neurological changes in the infected individuals.…”

“…To the best of our knowledge, our review gondii infection in Nigeria (32.92% [95% CI: 27.89−38.37]). 77 Toxoplasma gondii induces a suite of behavioral and neurological changes in the infected individuals. There are pronounced behavioral changes in the individual infected with T. gondii.…”

“…This finding is in line with the global pooled prevalence of T. gondii among HIV patients (35.8%; 95% CI: 30.8−40.7) 76 and the national overall pooled prevalence of human T. gondii infection in Nigeria (32.92% [95% CI: 27.89−38.37]). 77 Toxoplasma gondii induces a suite of behavioral and neurological changes in the infected individuals. There are pronounced behavioral changes in the individual infected with T. gondii .…”

Potential risk factors associated with seropositivity for Toxoplasma gondii among pregnant women and HIV infected individuals in Ethiopia: A systematic review and meta-analysis

“…In contrast, the present finding is higher than the global pooled prevalence estimates in pregnant women (1.1% to 33.8%) [11,13] and HIV infected individuals (3.24% to 44.2%) [1,5,14]. Significantly lower pooled seroprevalence reports in pregnant women and HIV/AIDS patients were also reported in Mexico (15.62% & 20.2%) [54], Iran (41% & 50.1%) [55,56] and Nigeria (40.3% & 31.7%) [57]. This variation might be attributable to the difference in local climatic situations which determine the survival of oocysts and favours the dissemination and sporulation of oocysts, nutritional habit, the status of public health and sanitary services, personal hygiene, sources of drinking water, socio-cultural differences, residence, stray or pet cat density and management, and levels of close contact with cats [1,7,13,17,[58][59][60].…”

Behavioral and Neuropathological Changes After Toxoplasma gondii Ocular Conjunctival Infection in BALB/c Mice

“…Toxoplasma gondii is an intracellular parasite that can infect most warm-blooded animals, where it may invade the central nervous system and provoke neuroinflammation and behavioral changes (for recent reviews, see Mendez and Koshy, 2017 ; Martinez et al., 2018 ; Chen et al., 2019 ; de Haan et al., 2021 ; Nasuhidehnavi and Yap, 2021 ; Nayeri et al., 2021 ; Postolache et al., 2021 ). It is estimated that approximately 30% of the world’s population is infected with this protozoan, but there is much greater prevalence in African and South American countries ( Agordzo et al., 2019 ; Karshima and Karshima, 2020 ; Rahmanian et al., 2020 ; de Lima Bessa et al., 2021 ). For example, in Brazil seroprevalence is 92%, but in the USA, it is only 22.5% ( Jones et al., 2001 ; Jones and Dubey, 2014 ).…”