The association between Toxoplasma infection and mortality: the NHANES epidemiologic follow-up study

Abstract

Background Toxoplasma gondii has been reported to be associated with higher mortality in patients with schizophrenia. This study aimed to explore the relationship between T. gondii infection and 25-year mortality based on data from the Third National Health and Nutrition Examination Survey (NHANES III) database. Methods Cases with serum T. gondii antibody test results were included in this study and the corresponding mortality dataset was obtained from the US National Center for Health Statistics (NCHS). Propensity score matching (PSM) was used to match age and sex between groups. The Cox proportional hazards model was used to evaluate the effect of T. gondii infection on mortality. Results A total of 14,181 cases were included in the analysis, of which 3831 (27.0%) were seropositive for T. gondii antibody. The median follow-up time of the whole cohort was 22.5 (interquartile range 16.3, 24.5) years. A total of 5082 deaths were observed in this cohort, a mortality rate of 35.8%. All-cause mortality was significantly higher in the seropositive group than in the seronegative group (50.0% vs 30.6%, P < 0.001). Kaplan–Meier analysis showed a significant difference in the survival time between two groups before and after PSM. Multivariate analysis showed that T. gondii infection was independently associated with higher all-cause mortality after adjusting for potential confounders. Conclusions Toxoplasma gondii infection is associated with higher mortality in general population. Graphical Abstract

A Comprehensive Review of Toxoplasmosis: Serious Threat to Human Health

“…Consuming raw shellfish and oysters has been identified as a significant risk factor for the spread of toxoplasmosis in a number of nations [78]. T. gondii infection affects between 25 and 30% of the world's population [79]. Many climatic factors influence oocyst survival rates, and ruminants play an important role in disease transmission [3].…”

The role of Nrf2 signaling in parasitic diseases and its therapeutic potential

“…Toxoplasma gondii is an obligate intracellular parasitic protozoan that causes toxoplasmosis in warm-blooded animals, like humans. Toxoplasmosis is an infection with high prevalence worldwide that can be life-threatening, especially in immunocompromised persons in congenital forms [ [80] , [81] , [82] , [83] , [84] ]. Human infections are usually acquired by the consumption of viable tissue cysts in contaminated raw meat or T. gondii oocysts in food or water.…”

Recent Advances in the Development of Adenovirus-Vectored Vaccines for Parasitic Infections

“…Although cases of severe disease are almost always limited to congenital and immunocompromised cases, a significant body of literature has identified correlations between T. gondii infection and a wide variety of conditions, especially neuropsychiatric diseases such as schizophrenia and psychosis [ 190 , 196 ]. A recently published analysis of ~14,000 individuals over ~22 years found a significantly higher all-cause mortality rate in seropositive versus seronegative individuals, indicating that there may be more to the story than we currently understand [ 197 ].…”