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Toxoplasmosis and Epilepsy — Systematic Review and Meta Analysis

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  • Edgard B Ngoungou
  • Devender Bhalla
  • Amandine Nzoghe
  • Marie-Laure Dardé
  • Pierre-Marie Preux

Abstract

Background: Toxoplasmosis is an important, widespread, parasitic infection caused by Toxoplasma gondii. The chronic infection in immunocompetent patients, usually considered as asymptomatic, is now suspected to be a risk factor for various neurological disorders, including epilepsy. We aimed to conduct a systematic review and meta-analysis of the available literature to estimate the risk of epilepsy due to toxoplasmosis. Methods: A systematic literature search was conducted of several databases and journals to identify studies published in English or French, without date restriction, which looked at toxoplasmosis (as exposure) and epilepsy (as disease) and met certain other inclusion criteria. The search was based on keywords and suitable combinations in English and French. Fixed and random effects models were used to determine odds ratios, and statistical significance was set at 5.0%. Principal findings: Six studies were identified, with an estimated total of 2888 subjects, of whom 1280 had epilepsy (477 positive for toxoplasmosis) and 1608 did not (503 positive for toxoplasmosis). The common odds ratio (calculated) by random effects model was 2.25 (95% CI 1.27–3.9), p = 0.005. Conclusions: Despite the limited number of studies, and a lack of high-quality data, toxoplasmosis should continue to be regarded as an epilepsy risk factor. More and better studies are needed to determine the real impact of this parasite on the occurrence of epilepsy. Author Summary: Toxoplasmosis is a common parasitic infection and affects one-third of the global population. The burden this figure represents clearly signifies the public health relevance of toxoplasmosis. Epilepsy, another chronic condition, is often caused by a variety of infections that affect numerous low- and middle-income tropical countries—including toxoplasmosis. Earlier meta-analysis found only three studies and reported a 4.8-fold greater risk of epilepsy. This had many limitations, as discussed in this paper, our estimate is rather more robust, based on a higher number of studies, and corrects deficiencies that were present previously.

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  • Edgard B Ngoungou & Devender Bhalla & Amandine Nzoghe & Marie-Laure Dardé & Pierre-Marie Preux, 2015. "Toxoplasmosis and Epilepsy — Systematic Review and Meta Analysis," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 9(2), pages 1-10, February.
    • Handle: RePEc:plo:pntd00:0003525
    DOI: 10.1371/journal.pntd.0003525
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    References listed on IDEAS

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    1. Tsang, Eric W. K., 2014. "Old and New," Management and Organization Review, Cambridge University Press, vol. 10(03), pages 390-390, November.
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    1. Tooran Nayeri Chegeni & Shahabeddin Sarvi & Afsaneh Amouei & Mahmood Moosazadeh & Zahra Hosseininejad & Sargis A. Aghayan & Ahmad Daryani, 2019. "Relationship between toxoplasmosis and obsessive compulsive disorder: A systematic review and meta-analysis," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 13(4), pages 1-13, April.

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