Associations of mental disorders and neurotropic parasitic diseases: a meta-analysis in developing and emerging countries
Résumé
Background: Although they are declining worldwide, neurotropic parasitic diseases are still common in developingand emerging countries. The aim of this study was to estimate the pooled prevalence and pooled associationmeasures of comorbidities between mental disorders (anxiety, depression, bipolar disorder, and schizophrenia) andneurotropic parasitic diseases (malaria, cysticercosis, toxoplasmosis, human African trypanosomiasis, Chagas disease,and human toxocariasis) in developing and emerging countries.Methods: As the first meta-analysis on this topic, this study was performed in accordance with PRISMA guidelines.The protocol was registered in PROSPERO (N°CRD42017056521). The Medline, Embase, Lilacs, and Institute ofEpidemiology and Tropical Neurology databases were used to search for articles without any restriction in languageor date. We evaluated the quality of studies independently by two investigators using the Downs and Blackassessment grid and pooled estimates using the random-effects method from CMA (Comprehensive Meta Analysis)Version 3.0.Results: In total, 18 studies published between 1997 and 2016 met our inclusion criteria. We found that theprevalence of anxiety and depression in people suffering from Chagas disease and/or neurocysticercosis was 44.9%(95% CI, 34.4–55.9). In 16 pooled studies that included 1782 people with mental disorders and 1776 controls,toxoplasmosis and/or toxocariasis were associated with increased risk of schizophrenia and/or bipolar disorders(odds ratio = 2.3; 95% CI, 1.7–3.2). Finally, toxocariasis and/or toxoplasmosis were associated with an increased risk ofthe onset of schizophrenia (odds ratio = 2.4; 95% CI, 1.7–3.4).Conclusion: Our pooled estimates show that the associations between diseases studied are relatively high indeveloping and emerging countries. This meta-analysis supports the hypothesis that toxoplasmosis could be thecause of schizophrenia. These findings could prove useful to researchers who want to further explore andunderstand the associations studied.
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