Seroprevalence and Risk Factor of Toxoplasmosis in Schizophrenia Patients Referred to Grhasia Psychiatric Hospital, Yogyakarta, Indonesia

Abstract

Background: Toxoplasmosis is an infectious disease caused by protozoan parasite called Toxoplasma gondii. Toxoplasma gondii is an intracellular protozoan parasite belong to phylum Apicomplexa, is an obligate parasite in mammals. The active proliferating trophozoites or tachyzoites are usually seen in the acute stage of infection, while the resting bradyzoites formed tissue cysts are primary found in muscle and brain. Human infection occurs mainly by ingesting food or water contaminated with oocyst or eating an undercook meat containing tissue cyst. Human might be infected via blood transfusion, organ transplantation or transplacenta transmission. Schizophrenia is a complex neuropsychiatric disease of the central nervous system, which contributing to behavioral changes which may resulted in higher risk to T. gondii infection. The purpose of this study were to know difference of seroprevalence and risk factor of toxoplasmosis between schizophrenia group and control group. Materials and Methods: Serum sample were collected 94 among schizophrenia patient at Grhasia Hospital and 64 normal population (control group). Antibody IgG of T. gondii was measured using ELISA method (Enzym Link Immnusorbent Assay) and questionnaires were used to collect risk factor data among the respondent. Results: The seroprevalence antibody IgG of patient with schizophrenia (69.14%) higher than control group (65.625%), but not significantly different (p>0.05). There was an association between some of risk factor with seropositive of toxoplasmosis in both group. In schizophrenia group, risk factor that associated with toxoplasmosis are uncooked meat consumption, contact with uncooked meat and soil, handwashing habit, uncooked water consumption, and water source. In control group, risk factor that associated are having cattles/pet, undercook meat consumption, and water source. Conclusion: This finding have shown seroprevalence of schizophrenia group higher than non-schizophrenia group and risk factor which associated with toxoplasmosis was different between two groups.

Neurological and Neurobehavioral Disorders Associated with Toxoplasma gondii Infection in Humans

“…gondii antibodies in both serum and cerebrospinal fluid in patients with recent-onset schizophrenia [ 14 , 15 ]. More recently, a study of 81,912 individuals from the Danish Blood Donor Study also found evidence that T. gondii and schizophrenia were statistically associated [ 177 ] while Muflikhah et al also showed that seropositivity was higher at 69% for the group of patients with schizophrenia compared to the control group at 66%; however, the latter was not considered statistically significant [ 178 ]. In addition, Alipour et al and Kezai et al showed a significant difference of the seropositivity rate between controls and patients with schizophrenia: specifically, 67.7% in patients with schizophrenia vs. 37.1% in control patients and 70% in patients with schizophrenia vs 52.9% in controls [ 179 , 180 ].…”

Toxoplasmosis Is More Frequent in Schizophrenia Patients Than in the General Population in Mexico and Is Not Associated with More Severe Course of Schizophrenia Measured with the Brief Psychiatric Rating Scale

“…Toxoplasma infection of the brain undoubtedly affects neuro-inflammatory processes, including microglial activation, the levels of inflammatory cytokines, and the number of peripheral immune cells occurring during the infection. All these biochemical and cellular processes alter behavior in various ways and might affect the risk of schizophrenia and the course of the disease [ 23 , 24 , 25 ].…”

“…Elevated antibody levels have also been linked to schizophrenia as compared with other patient groups [ 23 , 24 ]. The results of our study did not show a statistically significant correlation with antibody levels.…”

Restriction fragment length polymorphism analysis of genes of virulent strain isolate of Toxoplasma gondii using enzyme DdeI

“…The prevalence of T. gondii in the human population in Indonesia, one of the countries most intensely affected by this parasite, is estimated to be around 50% [7]. The seroprevalence of toxoplasmosis was reported to be 62.5% (394/630) and 67.7% (107/158) in Central Java and Yogyakarta, respectively [7,8]. In North Sulawesi, a high prevalence (58.5%; 501/856) was also reported in humans, but the rate was only 2.3% in pigs [7].…”