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A systematic review and meta-analysis of the prevalence of toxoplasmosis in hemodialysis patients in Iran.

ABSTRACT: Toxoplasmosis is a parasitic disease that occurs worldwide, with a wide range of complications in immunocompromised patients. This systematic review and meta-analysis was performed to evaluate the seroprevalence of Toxoplasma gondii among patients undergoing hemodialysis in Iran.We searched English and Persian databases for studies reporting T. gondii seroprevalence in Iranian hemodialysis patients through December 31, 2017. Inclusion and exclusion criteria were applied.A total of 10 studies containing 1,865 participants (1,048 patients and 817 controls) met the eligibility criteria. Immunoglobulin G (IgG) antibodies against T. gondii were found in 58% (95% confidence interval [CI], 46 to 70) of hemodialysis patients and 40% (95% CI, 31 to 50) of healthy controls, while immunoglobulin M (IgM) antibodies were found in 2% (95% CI, 0 to 6) of hemodialysis patients and 0% (95% CI, 0 to 1) of healthy controls. The meta-analysis showed that hemodialysis patients were significantly more likely to be seropositive for IgG (odds ratio [OR], 2.04; 95% CI, 1.54 to 2.70; p<0.001) and IgM (OR, 2.53; 95% CI, 1.23 to 5.22; p<0.001) antibodies against T. gondii infection than healthy individuals.The current study revealed a high prevalence of T. gondii infection in hemodialysis patients. Since hemodialysis patients are immunocompromised and T. gondii can cause serious clinical complications, we recommend that periodic screenings for T. gondii infection should be incorporated into the routine clinical care of these patients.

SUBMITTER: Foroutan M

PROVIDER: S-EPMC6060338 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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A systematic review and meta-analysis of the prevalence of toxoplasmosis in hemodialysis patients in Iran.

Foroutan Masoud M Rostami Ali A Majidiani Hamidreza H Riahi Seyed Mohammad SM Khazaei Sasan S Badri Milad M Badri Milad M Yousefi Elham E

Epidemiology and health 20180423

<h4>Objectives</h4>Toxoplasmosis is a parasitic disease that occurs worldwide, with a wide range of complications in immunocompromised patients. This systematic review and meta-analysis was performed to evaluate the seroprevalence of <i>Toxoplasma gondii</i> among patients undergoing hemodialysis in Iran.<h4>Methods</h4>We searched English and Persian databases for studies reporting <i>T. gondii</i> seroprevalence in Iranian hemodialysis patients through December 31, 2017. Inclusion and exclusio ...[more]

PMID: 29748456

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Project description:BackgroundMigraine headaches affect all ages, from childhood to old age. Migraine attacks cause significant changes in the living conditions of the sick person, including a decrease in personal, social, and occupational performance. This study was conducted to determine the prevalence of migraine in Iran through a systematic review and meta-analysis.MethodIn this systematic review and meta-analysis study, the studies associated with the prevalence of migraine using the keywords: migraine, prevalence, and Iran its equivalents in international databases PubMed, Web of Science, Scopus, Science direct, and Iranian internal information databases, including SID and MagIran, was searched without limit until November 2022. Comprehensive Meta-Analysis software (Version 2) was used to analyze the data. Due to the high number of studies reviewed in this systematic review, the Begg and Mazumdar test was used at a significance level of 0.1, and the corresponding Funnel plot was used to check publication bias. Also, the I2 test was used to check the heterogeneity in this study.Results22 records were included in the final analysis. The prevalence of migraine in the general population of Iran was 15.1% (confidence interval 95%: 10.7-20.9), and in this population, the prevalence of migraine was higher in women than in men. The prevalence of migraine based on The International Classification of Headache Disorders (ICHD) 2 criteria was reportedly 16.4% (95% CI: 10.8-24.1), and with ICHD3 criteria, this value was reported as 17.1% (95% CI: 7.7-33.6). Based on a survey of 4571 children, the prevalence of migraine was reported to be 5.2% (95% CI: 1.3-18.7). Also, the prevalence of migraine in adolescents was calculated based on eight studies (n = 8820). Accordingly, 11.2% (95% CI: 5.8-20.4) of adolescents have migraines. Meanwhile, the prevalence of migraine in boys was 8.2% (95% CI: 4.8-13.7), and in girls was 8% (95% CI: 6.2-12.7).ConclusionAs a result, the prevalence of migraine in Iran, based on population-based studies, was reported as 15.1%. The result showed a higher prevalence of migraine in the general population than in children and adolescents. It was also found that the prevalence of migraine in women is higher than in men.

Project description:Background A potential link between toxoplasmosis with schizophrenia (SCZ) has been extensively studied over the past 2 decades. Our study was aimed to determine whether, beyond an association, the field is primed for randomized clinical trials of anti‐Toxoplasma prophylaxis in Toxoplasma seropositive patients with SCZ. Methods We performed a methodological appraisal of toxoplasmosis‐SCZ association studies, a meta‐analysis, and a compilation of claims and pathophysiologic hypotheses. Results We analyzed 66 studies with 11,540 patients with SCZ and 69,491 controls. For patients with SCZ, 54 studies targeted Toxoplasma‐IgG seropositivity, 18 targeted Toxoplasma‐IgG serointensity, and 17 targeted Toxoplasma‐IgM seropositivity. For SCZ‐phenotypes, 26 targeted Toxoplasma‐IgG seropositivity, six targeted Toxoplasma‐IgG serointensity, and three targeted Toxoplasma‐IgM seropositivity. Two‐thirds of these studies reported a positive association. Statistically significant associations with SCZ were reported in 31/54 studies, 11/18 studies, and 3/17 studies. Significant associations with SCZ‐phenotypes were reported in 20/26 studies, 2/6 studies, and 0/3 studies, respectively. Toxoplasma‐IgG seropositivity increased the odds of SCZ (OR = 1.91; 95% CI: 1.61–2.27). Heterogeneity across studies was large (I2 = 80.03%). Adjusted analyses for at least age and socioeconomic status/place of residence were done in 17 studies; temporality was addressed only in 4. Conclusion A large number of observational studies revealed a modest to large association between toxoplasmosis and SCZ. Although important methodological biases were identified, further association studies are unlikely to change this association and are not justified. It is time to test this association in randomized double‐blind placebo‐controlled clinical trials of first line anti‐Toxoplasma prophylaxis in Toxoplasma seropositive patients with SCZ. Highlights We performed a methodological appraisal of 66 association studies published over the past 2 decades exploring the association between toxoplasmosis and schizophrenia (SCZ) or SCZ phenotypes, a meta‐analysis, and a compilation of claims and proposed pathophysiologic hypotheses. Two‐thirds of the studies reported a positive association and Toxoplasma‐IgG seropositivity was associated with an increase in the odds of SCZ; however, important methodological limitations were identified. Further association studies are unlikely to change this association and are not justified. It is time to test the hypothesis that prevention of intermittent subclinical reactivations of T.gondii in the brain of Toxoplasma seropositive patients with SCZ may have a positive impact in their SCZ‐course in randomized double‐blind placebo‐controlled clinical trial settings using first line anti‐Toxoplasma prophylaxis medications. Selection of first line primary‐prophylaxis anti‐Toxoplasma medication (such as trimethoprim/sulfamethoxazole), as has been the strategy in other clinical setting for high‐risk immunocompromised patients (e.g., Toxoplasma seropositive transplant patients or patients with acquired immune deficiency syndrome) is critical.

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A systematic review and meta-analysis of the prevalence of toxoplasmosis in hemodialysis patients in Iran.

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A systematic review and meta-analysis of the prevalence of toxoplasmosis in hemodialysis patients in Iran.

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