title: Toxoplasmosis--a global threat. Correlation of latent toxoplasmosis with specific disease burden in a set of 88 countries.
abstract: BACKGROUND
  Toxoplasmosis is becoming a global health hazard as it infects 30-50% of the world human population. Clinically, the life-long presence of the parasite in tissues of a majority of infected individuals is usually considered asymptomatic. However, a number of studies show that this 'asymptomatic infection' may also lead to development of other human pathologies.
  
  
  OBJECTIVE
  The purpose of the study was to collect available geoepidemiological data on seroprevalence of toxoplasmosis and search for its relationship with mortality and disability rates in different countries.
  
  
  RESULTS
  Prevalence data published between 1995-2008 for women in child-bearing age were collected for 88 countries (29 European). The association between prevalence of toxoplasmosis and specific disease burden estimated with age-standardized Disability Adjusted Life Year (DALY) or with mortality, was calculated using General Linear Method with Gross Domestic Product per capita (GDP), geolatitude and humidity as covariates, and also using nonparametric partial Kendall correlation test with GDP as a covariate. The prevalence of toxoplasmosis correlated with specific disease burden in particular countries explaining 23% of variability in disease burden in Europe. The analyses revealed that for example, DALY of 23 of 128 analyzed diseases and disease categories on the WHO list showed correlations (18 positive, 5 negative) with prevalence of toxoplasmosis and another 12 diseases showed positive trends (p<0.1). For several obtained significant correlations between the seroprevalence of toxoplasmosis and specific diseases/clinical entities, possible pathophysiological, biochemical and molecular explanations are presented.
  
  
  CONCLUSIONS
  The seroprevalence of toxoplasmosis correlated with various disease burden. Statistical associations does not necessarily mean causality. The precautionary principle suggests however that possible role of toxoplasmosis as a triggering factor responsible for development of several clinical entities deserves much more attention and financial support both in everyday medical practice and future clinical research.
authors.affiliation: Department of Biology, Faculty of Science, Charles University in Prague, Prague, Czech Republic.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Flegr
authors.affiliation: Department of Social Pediatrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Joseph
authors.initials: J
authors.lastname: Prandota
authors.affiliation: Department of Biology, Faculty of Science, Charles University in Prague, Prague, Czech Republic.
authors.forename: Michaela
authors.initials: M
authors.lastname: Sovičková
authors.affiliation: Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America.
authors.forename: Zafar H
authors.initials: ZH
authors.lastname: Israili
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data; D058070:Asymptomatic Diseases / Q000453:epidemiology*; D005260:Female; D005843:Geography; D059066:Gross Domestic Product; D006801:Humans; D006813:Humidity; D038622:Internationality; D008297:Male; D015995:Prevalence; D019057:Quality-Adjusted Life Years; D016036:Seroepidemiologic Studies; D013405:Suicide / Q000706:statistics & numerical data; D014123:Toxoplasmosis / Q000097:blood / Q000453:epidemiology* / Q000401:mortality / Q000635:transmission