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      Toxoplasma gondii Infection in Immunocompromised Patients: A Systematic Review and Meta-Analysis

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          Abstract

          Toxoplasma gondii has been suggested as an important opportunistic pathogen in immunocompromised patients. We conducted a global meta-analysis to assess the prevalence and odds ratios (ORs) of T. gondii infection in immunocompromised individuals. Electronic databases were reviewed for T. gondii infection in HIV/AIDS patients, cancer patients, and transplant recipients, and meta-analyses were conducted to calculate overall estimated prevalence and ORs using random or fixed-effects models. Totally, 72 eligible studies were included. The estimated pooled prevalence of T. gondii infection in immunocompromised patients and the control was 35.9 and 24.7% ( p < 0.001), with an OR of 2.24, i.e., 42.1 and 32.0% for HIV/AIDS patients and the control ( p < 0.05), 26.0 and 12.1% for cancer patients and the control ( p < 0.001), and 42.1 and 34.5% for transplant recipients and the control ( p > 0.05), whose estimated pooled ORs were 1.92 (95% CI, 1.44–2.55), 2.89 (95% CI, 2.36–3.55), and 1.51 (95% CI, 1.16–1.95), respectively. This study is the first to demonstrate that the immunocompromised patients are associated with higher odds of T. gondii infection, and appropriate prevention and control measures are highly recommended for these susceptible populations.

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          Waterborne transmission of protozoan parasites: review of worldwide outbreaks - an update 2004-2010.

          The present update gives a comprehensive review of worldwide waterborne parasitic protozoan outbreaks that occurred and were published globally between January 2004 and December 2010. At least one hundred and ninety-nine outbreaks of human diseases due to the waterborne transmission of parasitic protozoa occurred and were reported during the time period from 2004 to 2010. 46.7% of the documented outbreaks occurred on the Australian continent, 30.6% in North America and 16.5% in Europe. Cryptosporidium spp. was the etiological agent in 60.3% (120) of the outbreaks, Giardia lamblia in 35.2% (70) and other protozoa in 4.5% (9). Four outbreaks (2%) were caused by Toxoplasma gondii, three (1.5%) by Cyclospora cayetanensis. In two outbreaks (1%) Acanthamoeba spp. was identified as the causative agent. In one outbreak, G. lamblia (in 17.6% of stool samples) and Cryptosporidium parvum (in 2.7% of stool samples) as well as Entamoeba histolytica (in 9.4% of stool samples) and Blastocystis hominis (in 8.1% of stool samples) were detected. In those countries that are likely affected most a lack of surveillance systems is noticeable. However, countries that established surveillance systems did not establish an international standardization of reporting systems. Copyright © 2011 Elsevier Ltd. All rights reserved.
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            A review on human toxoplasmosis.

            Toxoplasmosis is a worldwide infection caused by the intracellular parasite Toxoplasma gondii. At least a third of the world human population are infected with the parasite, making it one of the most successful parasitic infections. Primary maternal infection may cause health-threatening sequelae for the foetus, or even cause death in uterus. Reactivation of a latent infection in immune deficiency conditions such as AIDS and organ transplantation can cause fatal toxoplasmic encephalitis. Toxoplasmosis is a major cause of retinochoroiditis, especially in individuals with an impaired immune system. Despite the usually 'asymptomatic' nature of the infection, a significant burden imposed by the parasite necessitates the implementation of effective means for the prevention, diagnosis, and management of this disease. Laboratory diagnosis, i.e. PCR and serologic assays, plays the main role in the diagnosis of congenital infection and assists in the confirmatory diagnosis of toxoplasmic encephalitis and ocular toxoplasmosis. Here, we briefly review general aspects of Toxoplasma infection and focus on the diagnostic methods currently used in medical laboratories for the diagnosis of Toxoplasma infection.
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              Diagnosis of toxoplasmosis and typing of Toxoplasma gondii

              Toxoplasmosis, caused by the obligate intracellular protozoan Toxoplasma gondii, is an important zoonosis with medical and veterinary importance worldwide. The disease is mainly contracted by ingesting undercooked or raw meat containing viable tissue cysts, or by ingesting food or water contaminated with oocysts. The diagnosis and genetic characterization of T. gondii infection is crucial for the surveillance, prevention and control of toxoplasmosis. Traditional approaches for the diagnosis of toxoplasmosis include etiological, immunological and imaging techniques. Diagnosis of toxoplasmosis has been improved by the emergence of molecular technologies to amplify parasite nucleic acids. Among these, polymerase chain reaction (PCR)-based molecular techniques have been useful for the genetic characterization of T. gondii. Serotyping methods based on polymorphic polypeptides have the potential to become the choice for typing T. gondii in humans and animals. In this review, we summarize conventional non-DNA-based diagnostic methods, and the DNA-based molecular techniques for the diagnosis and genetic characterization of T. gondii. These techniques have provided foundations for further development of more effective and accurate detection of T. gondii infection. These advances will contribute to an improved understanding of the epidemiology, prevention and control of toxoplasmosis.
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                Author and article information

                Contributors
                Journal
                Front Microbiol
                Front Microbiol
                Front. Microbiol.
                Frontiers in Microbiology
                Frontiers Media S.A.
                1664-302X
                09 March 2017
                2017
                : 8
                : 389
                Affiliations
                [1] 1College of Life Science, Jilin Agricultural University Changchun, China
                [2] 2State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences Lanzhou, China
                [3] 3Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Military Veterinary Institute, Academy of Military Medical Sciences Changchun, China
                [4] 4Department of Emergency Medicine, Inner Mongolia General Forestry Hospital Yakeshi, China
                [5] 5Medical Library of the Chinese people's Liberation Army Beijing, China
                [6] 6Center for Prevention and Control of Animal Diseases of Banan District in Chongqing Chongqing, China
                [7] 7Key Laboratory of Zoonoses, Ministry of Education Changchun, China
                Author notes

                Edited by: James H. McKerrow, University of California, San Diego, USA

                Reviewed by: Lars Eckmann, University of California, San Diego, USA; Veeranoot Nissapatorn, University of Malaya, Malaysia; Ziguo Yuan, South China Agricultural University, China

                *Correspondence: Quan Liu liuquan1973@ 123456hotmail.com

                This article was submitted to Infectious Diseases, a section of the journal Frontiers in Microbiology

                Article
                10.3389/fmicb.2017.00389
                5343064
                28337191
                aa429855-a99d-463c-80b6-d0ce1f3688c1
                Copyright © 2017 Wang, Liu, Ma, Ma, Li, Yang, Zhu, Xu, Wei and Liu.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 25 October 2016
                : 24 February 2017
                Page count
                Figures: 5, Tables: 4, Equations: 0, References: 113, Pages: 12, Words: 8622
                Categories
                Microbiology
                Original Research

                Microbiology & Virology
                toxoplasma gondii,immunocompromised patients,hiv/aids patients,cancer patients,transplant recipients,prevalence,odds ratio

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