Toxoplasmosis in Pregnant Women and HIV/AIDS Patients in Ethiopia: A Systematic Review and Meta-Analysis

Abstract

Background Although Toxoplasma gondii infection in immune-competent individuals is usually asymptomatic or causes a mild flu-like illness, it may become severe and can occasionally be fatal in immune-compromised people, such as AIDS patients or pregnant women. Method Electronic English databases (Pubmed, Google Scholar, Science Direct, and Scopus), parasitology congresses, and theses of Ethiopian medical universities, were systematically searched (published or unpublished data). Full-length articles and abstracts were collected using keywords such as Toxoplasma gondii, Toxoplasmosis, pregnant women, HIV/AIDS, and Ethiopia. Results Analysis of seroprevalence estimates was pooled using a random effects meta-analysis. Seventeen studies were included in the present systematic review and meta-analysis. One of these studies reported seroprevalence of T. gondii in HIV/AIDS patients and pregnant women. In this review, a total of 4,030 individuals were included and analyzed. The pooled prevalence of T. gondii in this review was 81.00% (95% CI = 69.10–89.78). Sub-group analysis showed that 2,557 pregnant women were evaluated. In pregnant women, the pooled sero-prevalence was 71.2 (95% CI = [51.9%, 87.1%]. In HIV/AIDS patients, 1,473 individuals were evaluated and the pooled seroprevalence was 88.45 (95% CI = 80.87%–94.31%). Conclusion This systematic review and meta-analysis identified a high seroprevalence of Toxoplasma infection of 81% among immunocompromised patients. Scaling up prevention and control methods mainly strengthening educational efforts are necessary to avoid reactivation and to stop the spread of T. gondii infection.

Serosurvey of anti-Toxoplasma gondii and anti-HIV antibodies in homeless persons of southeastern Brazil

“…Despite the HIV seroprevalence of 2/120 (1.7%) in homeless persons was above the estimated prevalence of 0.4% for the general Brazilian population and lower than a recent study with 69/1,402 Although T. gondii and HIV co-infection has been widely studied due to the consequences that may occur in pregnant women and immunocompromised persons, no study to date has focused on the homeless population. Despite previous studies have shown a high prevalence of such coinfection, with 35.8% worldwide in a meta-analysis study and up to 88.4% of individuals coinfected in Ethiopia [39,40], analysis of associated risk factor was not possible herein due to low HIV positive rate.…”

“…HIV patients have also been associated with increased susceptibility of T. gondii invasion into the central nervous system and toxoplasmic encephalitis, mostly caused by bradyzoite conversion to active forms and rapidly replicating tachyzoites [35][36][37][38]. HIV-T. gondii co-infection prevalence varies widely in general populations, from 35.8% worldwide and up to 88.4% in Ethiopian individuals, according to meta-analysis studies [39,40]. Other vulnerable populations also presented HIV-T. gondii co-infection, such as in 31/42 (73.8%) drug users in Iran and 84/342 (24.6%) drug users in China [41,42].…”

Serosurvey of Anti-Toxoplasma gondii Antibodies in Homeless Persons of São Paulo City, Southeastern Brazil

“…In the present study, 2/120 (1.7%) homeless persons was positive to anti-HIV antibodies, above the estimated prevalence of 0.4% for the general Brazilian population and lower than a recent study with 69/1,402 (4.9%) seropositive homeless (22,56). Despite previous studies have shown a high prevalence of T. gondii and HIV co-infection, with 35.8% worldwide in a meta-analysis study and up to 88.4% of individuals coinfected in Ethiopia (57,58), the analysis of associated risk factors herein has been impaired due to low HIV positive frequency.…”

Serosurvey of anti-Toxoplasma gondii antibodies in homeless persons of São Paulo city, southeastern Brazil

“…In the present study, 2/120 (1.7%) homeless persons was positive to anti-HIV antibodies, above the estimated prevalence of 0.4% for the general Brazilian population and lower than a recent study with 69/1,402 (4.9%) seropositive homeless. Despite previous studies have shown a high prevalence of T. gondii and HIV co-infection, with 35.8% worldwide in a meta-analysis study and up to 88.4% of individuals coinfected in Ethiopia [54,55], the analysis of associated risk factors herein has been impaired due to low HIV positive frequency.…”