Epidemiol Health.
2018;40:e2018016. 10.4178/epih.e2018016.
A systematic review and meta-analysis of the prevalence of toxoplasmosis in hemodialysis patients in Iran
- Affiliations
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- 1Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
- 2Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. alirostami1984@gmail.com
- 3Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- 4Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran.
- 5Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- KMID: 2438471
- DOI: http://doi.org/10.4178/epih.e2018016
Abstract
OBJECTIVES
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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.
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