{"title":"散发性弓形虫病的危险因素:系统回顾和荟萃分析","authors":"Anne Thebault , Pauline Kooh , Vasco Cadavez , Ursula Gonzales-Barron , Isabelle Villena","doi":"10.1016/j.mran.2020.100133","DOIUrl":null,"url":null,"abstract":"<div><p><span>Toxoplasmosis<span> is considered as the most prevalent parasitic zoonotic infection worldwide. The parasitic cycle is mostly known, but the relative contribution of different sources and pathways of transmission was not previously studied by a meta-analysis. A systematic review and a meta-analysis of case-control, cohort, and cross-sectional studies were performed to determine the main risk factors associated with sporadic </span></span><span><em>Toxoplasma</em></span> infection. Suitable scientific articles were identified through a systematic literature search and subjected to a methodological quality assessment. Mixed-effects meta-analysis models were adjusted by population type – children, mixed population, and pregnant women – to appropriate data partitions. 187 primary studies passed the quality assessment stage, investigating risk factors for sporadic infection with <span><em>Toxoplasma gondii</em></span><span> conducted between 1983 and 2016. Cases were defined by serology.</span></p><p>The meta-analysis of <em>Toxoplasma</em><span> sporadic infections revealed the significance of transmission by environmental factors such as contact with soil and contact with animals, in particular cats. The consumption of raw or undercooked meat and unwashed vegetables significantly increased the odds of acquiring the disease. Shellfish and raw milk were identified as significant sources of toxoplasmosis. Almost all meat categories were identified as risk factors: pork, poultry, beef, processed meat, lamb, and game meat. Contaminated drinking water may play a role in the acquisition of infection. Moreover, the lack of hygiene in preparing food was identified as a risk factor. A significant risk factor for pregnant women is traveling abroad. Lastly, blood transfusion (in pregnant women) and immunocompromised conditions were found associated with positive serology. The broad definition of exposures and the use of serology for the case definition are the main limitations for the interpretation of the results of this meta-analysis. The transmission pathways require further investigations using longitudinal studies and subtyping approaches.</span></p></div>","PeriodicalId":48593,"journal":{"name":"Microbial Risk Analysis","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.mran.2020.100133","citationCount":"12","resultStr":"{\"title\":\"Risk factors for sporadic toxoplasmosis: A systematic review and meta-analysis\",\"authors\":\"Anne Thebault , Pauline Kooh , Vasco Cadavez , Ursula Gonzales-Barron , Isabelle Villena\",\"doi\":\"10.1016/j.mran.2020.100133\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p><span>Toxoplasmosis<span> is considered as the most prevalent parasitic zoonotic infection worldwide. The parasitic cycle is mostly known, but the relative contribution of different sources and pathways of transmission was not previously studied by a meta-analysis. A systematic review and a meta-analysis of case-control, cohort, and cross-sectional studies were performed to determine the main risk factors associated with sporadic </span></span><span><em>Toxoplasma</em></span> infection. Suitable scientific articles were identified through a systematic literature search and subjected to a methodological quality assessment. Mixed-effects meta-analysis models were adjusted by population type – children, mixed population, and pregnant women – to appropriate data partitions. 187 primary studies passed the quality assessment stage, investigating risk factors for sporadic infection with <span><em>Toxoplasma gondii</em></span><span> conducted between 1983 and 2016. Cases were defined by serology.</span></p><p>The meta-analysis of <em>Toxoplasma</em><span> sporadic infections revealed the significance of transmission by environmental factors such as contact with soil and contact with animals, in particular cats. The consumption of raw or undercooked meat and unwashed vegetables significantly increased the odds of acquiring the disease. Shellfish and raw milk were identified as significant sources of toxoplasmosis. Almost all meat categories were identified as risk factors: pork, poultry, beef, processed meat, lamb, and game meat. Contaminated drinking water may play a role in the acquisition of infection. Moreover, the lack of hygiene in preparing food was identified as a risk factor. A significant risk factor for pregnant women is traveling abroad. Lastly, blood transfusion (in pregnant women) and immunocompromised conditions were found associated with positive serology. The broad definition of exposures and the use of serology for the case definition are the main limitations for the interpretation of the results of this meta-analysis. The transmission pathways require further investigations using longitudinal studies and subtyping approaches.</span></p></div>\",\"PeriodicalId\":48593,\"journal\":{\"name\":\"Microbial Risk Analysis\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2021-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.mran.2020.100133\",\"citationCount\":\"12\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Microbial Risk Analysis\",\"FirstCategoryId\":\"93\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2352352220300396\",\"RegionNum\":4,\"RegionCategory\":\"环境科学与生态学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENVIRONMENTAL SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Microbial Risk Analysis","FirstCategoryId":"93","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352352220300396","RegionNum":4,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENVIRONMENTAL SCIENCES","Score":null,"Total":0}
Risk factors for sporadic toxoplasmosis: A systematic review and meta-analysis
Toxoplasmosis is considered as the most prevalent parasitic zoonotic infection worldwide. The parasitic cycle is mostly known, but the relative contribution of different sources and pathways of transmission was not previously studied by a meta-analysis. A systematic review and a meta-analysis of case-control, cohort, and cross-sectional studies were performed to determine the main risk factors associated with sporadic Toxoplasma infection. Suitable scientific articles were identified through a systematic literature search and subjected to a methodological quality assessment. Mixed-effects meta-analysis models were adjusted by population type – children, mixed population, and pregnant women – to appropriate data partitions. 187 primary studies passed the quality assessment stage, investigating risk factors for sporadic infection with Toxoplasma gondii conducted between 1983 and 2016. Cases were defined by serology.
The meta-analysis of Toxoplasma sporadic infections revealed the significance of transmission by environmental factors such as contact with soil and contact with animals, in particular cats. The consumption of raw or undercooked meat and unwashed vegetables significantly increased the odds of acquiring the disease. Shellfish and raw milk were identified as significant sources of toxoplasmosis. Almost all meat categories were identified as risk factors: pork, poultry, beef, processed meat, lamb, and game meat. Contaminated drinking water may play a role in the acquisition of infection. Moreover, the lack of hygiene in preparing food was identified as a risk factor. A significant risk factor for pregnant women is traveling abroad. Lastly, blood transfusion (in pregnant women) and immunocompromised conditions were found associated with positive serology. The broad definition of exposures and the use of serology for the case definition are the main limitations for the interpretation of the results of this meta-analysis. The transmission pathways require further investigations using longitudinal studies and subtyping approaches.
期刊介绍:
The journal Microbial Risk Analysis accepts articles dealing with the study of risk analysis applied to microbial hazards. Manuscripts should at least cover any of the components of risk assessment (risk characterization, exposure assessment, etc.), risk management and/or risk communication in any microbiology field (clinical, environmental, food, veterinary, etc.). This journal also accepts article dealing with predictive microbiology, quantitative microbial ecology, mathematical modeling, risk studies applied to microbial ecology, quantitative microbiology for epidemiological studies, statistical methods applied to microbiology, and laws and regulatory policies aimed at lessening the risk of microbial hazards. Work focusing on risk studies of viruses, parasites, microbial toxins, antimicrobial resistant organisms, genetically modified organisms (GMOs), and recombinant DNA products are also acceptable.