散发性弓形虫病的危险因素:系统回顾和荟萃分析

IF 3 4区 环境科学与生态学 Q2 ENVIRONMENTAL SCIENCES Microbial Risk Analysis Pub Date : 2021-04-01 DOI:10.1016/j.mran.2020.100133
Anne Thebault , Pauline Kooh , Vasco Cadavez , Ursula Gonzales-Barron , Isabelle Villena
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引用次数: 12

摘要

弓形虫病被认为是世界上最普遍的寄生虫感染。寄生虫周期是众所周知的,但不同来源和传播途径的相对贡献以前没有通过荟萃分析进行研究。对病例对照、队列和横断面研究进行了系统回顾和荟萃分析,以确定与散发性弓形虫感染相关的主要危险因素。通过系统的文献检索确定合适的科学文章,并进行方法学质量评估。混合效应荟萃分析模型根据人群类型(儿童、混合人群和孕妇)调整到适当的数据分区。187项初步研究通过了质量评估阶段,调查了1983 - 2016年间刚地弓形虫散发感染的危险因素。病例以血清学诊断。对散发性弓形虫感染的荟萃分析显示,环境因素(如与土壤接触和与动物(尤其是猫)接触)对弓形虫的传播具有重要意义。食用生的或未煮熟的肉和未洗的蔬菜大大增加了患这种疾病的几率。贝类和原料牛奶被确定为弓形虫病的重要来源。几乎所有肉类类别都被确定为危险因素:猪肉、家禽、牛肉、加工肉类、羊肉和野味。受污染的饮用水可能在感染中起作用。此外,在准备食物时缺乏卫生被认为是一个危险因素。孕妇的一个重要危险因素是出国旅行。最后,输血(孕妇)和免疫功能低下的情况与血清学阳性有关。暴露的广泛定义和病例定义使用血清学是解释本荟萃分析结果的主要限制。传播途径需要使用纵向研究和分型方法进行进一步调查。
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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.

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来源期刊
Microbial Risk Analysis
Microbial Risk Analysis Medicine-Microbiology (medical)
CiteScore
5.70
自引率
7.10%
发文量
28
审稿时长
52 days
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.
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