Toxoplasmosis – a global threat. Correlation of latent toxoplasmosis with specific disease burden in a set of 88 countri
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Flegr, J., Prandota, J., Sovicková, M., Israili, ZH.
PLoS ONE 9(3): e90203. doi:10.1371/journal.pone.0090203, 2014
Flegr, J., Prandota, J., Sovicková, M., Israili, ZH.
PLoS ONE 9(3): e90203. doi:10.1371/journal.pone.0090203, 2014
Click for abstract
Background:
Toxoplasmosis is becoming a global health hazard as it infects 30–50% of the world human population.
Clinically, the life-long presence of the parasite in tissues of a majority of infected individuals is usually considered
asymptomatic. However, a number of studies show that this ‘asymptomatic infection’ may also lead to development of
other human pathologies.
Aims of the Study:
The purpose of the study was to collect available geoepidemiological data on seroprevalence of
toxoplasmosis and search for its relationship with mortality and disability rates in different countries.
Methods and Findings:
Prevalence data published between 1995–2008 for women in child-bearing age were collected for
88 countries (29 European). The association between prevalence of toxoplasmosis and specific disease burden estimated
with age-standardized Disability Adjusted Life Year (DALY) or with mortality, was calculated using General Linear Method
with Gross Domestic Product per capita (GDP), geolatitude and humidity as covariates, and also using nonparametric partial
Kendall correlation test with GDP as a covariate. The prevalence of toxoplasmosis correlated with specific disease burden in
particular countries explaining 23% of variability in disease burden in Europe. The analyses revealed that for example, DALY
of 23 of 128 analyzed diseases and disease categories on the WHO list showed correlations (18 positive, 5 negative) with
prevalence of toxoplasmosis and another 12 diseases showed positive trends (p
,
0.1). For several obtained significant
correlations between the seroprevalence of toxoplasmosis and specific diseases/clinical entities, possible pathophysiolog-
ical, biochemical and molecular explanations are presented.
Conclusions:
The seroprevalence of toxoplasmosis correlated with various disease burden. Statistical associations does not
necessarily mean causality. The precautionary principle suggests however that possible role of toxoplasmosis as a triggering
factor responsible for development of several clinical entities deserves much more attention and financial support both in
everyday medical practice and future clinical research.