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Epidemiology and Health 2018;e2018016.
DOI: https://doi.org/10.4178/epih.e2018016    [Accepted] Published online April 23, 2018.
A systematic review and meta-analysis of the prevalence of toxoplasmosis in hemodialysis patients in Iran
Masoud Foroutan1  , Ali Rostami2  , Hamidreza Majidiani1  , Seyed Mohammad Riahi3,4  , Sasan Khazaei1  , Milad Badri1  , Elham Yousefi5 
1Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
2Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran
3Department of Epidemiology, School of Public health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran
5Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Correspondence  Ali Rostami ,Tel: +989113201835, Fax: +989113201835, Email: alirostami1984@gmail.com
Submitted: March 31, 2018  Accepted after revision: April 23, 2018
Toxoplasmosis is a worldwide distributed parasitic disease with wide range of complications in immunocompromised patients. This systematic review and meta-analysis study was performed to evaluate the seroprevalence of Toxoplasma gondii (T. gondii) among patients undergoing hemodialysis patients in Iran.
We searched the English and Persian databases for studies reporting T. gondii seroprevalence in Iranian hemodialysis patients up to 31 December 2017. Inclusion and exclusion criteria were applied.
A total of 10 studies containing 1865 participants (1048 patients and 817 controls) met the eligibility criteria. T. gondii antibodies were reported in 58% (95% CI, 46–70) vs. 40% (95% CI, 31–50) and 2% (95% CI, 0–6) vs. 0.0% (95% CI, 0–1) for the IgG and IgM among hemodialysis patients and healthy controls, respectively. Based on meta-analysis results, hemodialysis patients were significantly more likely to be seropositive for IgG- (OR = 2.04; 95% CI = 1.54–2.7; P < 0.001) and IgM- (OR = 2.53; 95% CI = 1.23–5.22; P < 0.001) antibodies against T. gondii infection compared to healthy individuals.
The current study revealed a high prevalence of T. gondii infection in hemodialysis patients. Since hemodialysis patients are immunocompromised and T. gondii can cause serious clinical complications, we recommend that T. gondii infection screening and periodic repetition should be incorporated into the routine clinical care of these patients.
Keywords: Toxoplasma gondii; Seroprevalence; Hemodialysis patients; Iran


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