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      Seroprevalence of Toxoplasma gondii infection in blood donors in mainland China: a systematic review and meta-analysis Translated title: Séroprévalence de l’infection par Toxoplasma gondii chez les donneurs de sang en Chine continentale: examen systématique et méta-analyse

      1 , 1 , 2 , 2 , 3 , 4 , *

      Parasite

      EDP Sciences

      Toxoplasma gondii, Blood donors, China, Systematic review, Meta-analysis

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          Abstract

          Toxoplasma gondii transmitted from blood donors to receiving patients has become a concern as numerous articles about the epidemiology of T. gondii infection in blood donors from different provinces have been published in China. This study aimed to evaluate the seroprevalence of T. gondii infection in Chinese blood donors using a meta-analysis. A total of 40 eligible studies, published from 1986 to 2017 and covering 18 provinces and municipalities were included. Among a total of 49,784 Chinese blood donors, the overall IgG seroprevalence of T. gondii infection was 6.26% (95% CI: 4.62%–8.13%). The highest prevalence was in the Northeast of China and the lowest in Central China. The infection rate increased slowly over the years, but not significantly. A statistically significant correlation was found between the seroprevalence of T. gondii infection and the detection method and educational level ( p < 0.01). There was no relationship between age, gender, occupation and blood type and seroprevalence of T. gondii ( p > 0.05). The prevalence of antibodies to T. gondii in Chinese blood donors was lower than in other countries, but the risk of transfusion-transmitted toxoplasmosis still exits. More concise methods are still needed to evaluate the possibility of transfusion-transmitted toxoplasmosis from blood donors.

          Translated abstract

          La transmission de Toxoplasma gondii des donneurs de sang aux patients receveurs est devenue un sujet de préoccupation car de nombreux articles sur l’épidémiologie de l’infection à T. gondii chez des donneurs de sang de différentes provinces ont été publiés en Chine. Cette étude visait à évaluer la séroprévalence de l’infection par T. gondii chez des donneurs de sang chinois à l’aide d’une méta-analyse. Un total de 40 études admissibles, publiées de 1986 à 2017 et couvrant 18 provinces et municipalités, ont été incluses. Sur un total de 49 784 donneurs de sang chinois, la séroprévalence globale des IgG de l’infection à T. gondii était de 6,26% (IC à 95%: 4,62%-8,13%). La prévalence la plus élevée était au nord-est de la Chine et la plus faible en Chine centrale. Le taux d’infection a augmenté lentement au cours des années, mais pas de manière significative. Une corrélation statistiquement significative a été trouvée entre la séroprévalence de l’infection par T. gondii et la méthode de détection et le niveau d’éducation (p < 0,01). Il n’y avait pas de relation entre l’âge, le sexe, la profession, le type sanguin et la séroprévalence de T. gondii (p > 0,05). La prévalence des anticorps contre T. gondii chez les donneurs de sang chinois est plus faible que dans les autres pays, mais le risque de toxoplasmose transmise par transfusion existe toujours. Des méthodes plus concises sont encore nécessaires pour évaluer la possibilité de toxoplasmose transmise par transfusion chez les donneurs de sang.

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            Seroepidemiology of human Toxoplasma gondii infection in China

            Background Toxoplasmosis is an important zoonotic parasitic disease worldwide. In immune competent individuals, Toxoplasma gondii preferentially infects tissues of central nervous systems, which might be an adding factor of certain psychiatric disorders. Congenital transmission of T. gondii during pregnancy has been regarded as a risk factor for the health of newborn infants. While in immune-compromised individuals, the parasite can cause life-threatening infections. This study aims to investigate the prevalence of T. gondii infection among clinically healthy individuals and patients with psychiatric disorders in China and to identify the potential risk factors related to the vulnerability of infection in the population. Methods Serum samples from 2634 healthy individuals and 547 patients with certain psychiatric disorders in Changchun and Daqing in the northeast, and in Shanghai in the south of China were examined respectively for the levels of anti-T. gondii IgG by indirect ELISA and a direct agglutination assay. Prevalence of T. gondii infection in the Chinese population in respect of gender, age, residence and health status was systematically analyzed. Results The overall anti-T. gondii IgG prevalence in the study population was 12.3%. In the clinically healthy population 12.5% was sero-positive and in the group with psychiatric disorders 11.3% of these patients were positive with anti-T. gondii IgG. A significant difference (P = 0.004) was found between male and female in the healthy population, the seroprevalence was 10.5% in men versus 14.3% in women. Furthermore, the difference of T. gondii infection rate between male and female in the 20-19 year's group was more obvious, with 6.4% in male population and 14.6% in female population. Conclusion A significant higher prevalence of T. gondii infection was observed in female in the clinically healthy population. No correlation was found between T. gondii infection and psychiatric disorders in this study. Results suggest that women are more exposed to T. gondii infection than men in China. The data argue for deeper investigations for the potential risk factors that threat the female populations.
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              Toxoplasmosis in Blood Donors: A Systematic Review and Meta-Analysis.

              Transfusion-transmissible infections include pathogens that may cause severe and debilitating diseases. Toxoplasmosis is a cosmopolitan neglected parasitic infection that can lead to severe complications including death in immune-compromised patients or following infection in utero. Multiple studies have demonstrated the transmission of Toxoplasma gondii by blood transfusion. The objective of this review was to comprehensively assess the seroprevalence rate of Toxoplasma in blood donors from a worldwide perspective. Seven electronic databases (PubMed, Science Direct, Web of Science, Scopus, Cochrane, Ovid, and Google Scholar) were searched using medical subject headings terms. A total of 43 records met the inclusion criteria in which 20,964 donors were tested during the period from January 1980 to June 2015. The overall weighted prevalence of exposure to toxoplasmosis in blood donors was 33% (95% confidence interval [CI], 28%-39%). The seroprevalences of immunoglobulin (Ig)M and both IgG and IgM antibodies were 1.8% (95% CI, 1.1%-2.4%) and 1.1% (95% CI, 0.3%-1.8%), respectively. The highest and the lowest seroprevalences of toxoplasmosis were observed in Africa (46%; 95% CI, 14%-78%) and in Asia (29%; 95% CI, 23%-35%), respectively. Brazil (75%) and Ethiopia (73%) were identified as countries with high seroprevalence. Because positive serology does not imply infectiousness and because seroprevalence is high in some nations, a positive serology test result alone cannot be used as an effective method for donor screening. Future research for methods to prevent transfusion-transmitted toxoplasmosis may derive benefit from studies conducted in areas of high endemicity.
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                Author and article information

                Journal
                Parasite
                Parasite
                parasite
                Parasite
                EDP Sciences
                1252-607X
                1776-1042
                2018
                23 July 2018
                : 25
                : ( publisher-idID: parasite/2018/01 )
                Affiliations
                [1 ] Research Institute for Medicine of Nanjing Command 293 Zhongshan Eastern Road Nanjing 210002 PR China
                [2 ] Gaoyou Hospital Affiliated to Soochow University (Gaoyou People’s Hospital) Gaoyou 225600 PR China
                [3 ] Faculty of Preventive Medicine, The Fourth Military Medical University 169 Changle West Road Xi’an 710032 PR China
                [4 ] Jiangsu Province Blood Center 179 Longpan Road Nanjing 210042 Jiangsu PR China
                Author notes
                [†]

                These authors contributed equally to this work.

                [* ]Corresponding author: linhong712003@ 123456sina.com
                Article
                parasite180051 10.1051/parasite/2018037
                10.1051/parasite/2018037
                6057739
                30040610
                © T. Wang et al., published by EDP Sciences, 2018

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 5, Tables: 3, Equations: 0, References: 62, Pages: 10
                Categories
                Research Article

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