A systematic review and meta-analysis of protozoan parasite infections among patients with mental health disorders: an overlooked phenomenon

Abdoli, Amir; Olfatifar, Meysam; Eslahi, Aida Vafae; Moghadamizad, Zeinab; Samimi, Rasoul; Habibi, Mohammad Amin; Kianimoghadam, Amir Sam; Badri, Milad; Karanis, Panagiotis

doi:10.1186/s13099-024-00602-2

Gut Pathogens

Table 1 Main characteristics of the included case–control studies reporting the prevalence of protozoan parasitic infections among patients with mental disorders

From: A systematic review and meta-analysis of protozoan parasite infections among patients with mental health disorders: an overlooked phenomenon

Study No	Author	Year	Study Years	Subjects type	Mental disorder	Continent	Diagnostic method	Case Size	Infected	Mean age	Control Size	Infected	Mean age	Species of parasites
1	Yolken et al.	2001	1998–1999	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Europe	EIA & Western Blot	38	16	27	27	3	–	Toxoplasma gondii
2	Brown et al.	2005	1959–1967	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	North America	Sabin-Feldman Dye Test	63	25	–	123	30	–	Toxoplasma gondii
3	El-Sahn et al.	2005	–	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Africa	EIA	75	60	–	85	45	–	Toxoplasma gondii
4	Alvarado-Esquivel et al.	2006	2005–2006	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	North America	ELISA	137	25	43.7	180	16	42	Toxoplasma gondii
5	Wang et al.	2006	–	Hospitalized/Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders, Bipolar and Related Disorder	Asia	ELISA	1200	170	22.63	400	23	–	Toxoplasma gondii
6	Akyol et al.	2006	2003	Non hospitalized	Neurocognitive disorders	Asia	ELISA	100	31	28.88	50	10	27.56	Toxoplasma gondii
7	Mokhtari et al.	2006	–	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	230	41	–	230	17	–	Toxoplasma gondii
8	Cetinkaya et al.	2007	–	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	100	66	37.25	100	23	–	Toxoplasma gondii
9	Saraei-Sahnesaraei et al.	2007	–	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	103	57	35.36	114	58	–	Toxoplasma gondii
10	Tamer et al.	2008	2004–2005	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	40	16	–	37	5	–	Toxoplasma gondii
11	Yuksel et al.	2008	–	Non hospitalized	Schizophrenia and Other Psychotic Disorders	Asia	ELISA & Sabin-Feldman Dye Test	450	237	–	150	68	–	Toxoplasma gondii
12	Dogruman-Al et al	2009	2007–2008	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	88	42	38.5	88	19	29.2	Toxoplasma gondii
13	Xiao et al.	2009	–	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	North America	ELISA	219	91	–	613	215	–	Toxoplasma gondii
14	Saraei-Sahnesaraei et al.	2009	–	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	103	41	–	114	80	–	Toxoplasma gondii
15	Mahmoud et al.	2009	–	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	96	55	38.25	96	22	–	Toxoplasma gondii
16	Daryani et al.	2010	2009	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	80	55	32.95	91	61	–	Toxoplasma gondii
17	Miman et al.	2010	2008	Non hospitalized	Obsessive–Compulsive and Related Disorders	Asia	ELISA	42	20	34.05	100	19	38.1	Toxoplasma gondii
18	Tanyuksel et al.	2010	2002–2006	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA & Sabin-Feldman Dye Test	70	32	23.4	40	15	30.3	Toxoplasma gondii
19	Xiao et al.	2010	2006–2008	Non hospitalized	Bipolar and Related Disorder, Trauma and Stressor Related Disorder, Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	914	99	–	2634	328	–	Toxoplasma gondii
20	Yuksel et al.	2010	2007	Hospitalized	Obsessive–Compulsive and Related Disorders	Asia	ELISA	300	182	42.6	300	123	–	Toxoplasma gondii
21	Krause et al.	2010	–	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Europe	ELISA	31	12	36.7	30	6	33.7	Toxoplasma gondii
22	Hamidinejat et al.	2010	–	Hospitalized/Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	144	77	33	48	16	–	Toxoplasma gondii
23	Alipour et al.	2011	2009–2010	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	62	42	37.54	62	23	37.24	Toxoplasma gondii
24	Alvarado-Esquivel et al.	2011	2009–2010	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	North America	ELISA	50	10	45.12	150	8	45.1	Toxoplasma gondii
25	Liu ET et al.	2011	–	Hospitalized	Bipolar and Related Disorder	Asia	ELISA	477	112	29.86	210	12	28.12	Toxoplasma gondii
26	Mortensen et al.	2011	1991–1994	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Europe	Optical density	127	33	–	127	26	–	Toxoplasma gondii
27	Bamne et al.	2012	–	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	North America	ELISA	604	159	–	404	83	–	Toxoplasma gondii
28	Horacek et al.	2012	–	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Europe	ELISA & CFT	44	12	30.82	56	13	27.89	Toxoplasma gondii
29	Nascimento et al.	2012	–	Non hospitalized	Depressive Disorder, Schizophrenia Spectrum and Other Psychotic Disorders	South America	ELISA & ELFA	79	38	32.7	95	27	38.2	Toxoplasma gondii
30	Park et al.	2012	2010–2011	Hospitalized/Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA & IFA	96	21	46.14	50	4	44.8	Toxoplasma gondii
31	Emelia et al.	2012	2011	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	144	54	–	144	49	–	Toxoplasma gondii
32	El-Sayed et al.	2012	–	Hospitalized/Non hospitalized	Depressive Disorder, Schizophrenia Spectrum and Other Psychotic Disorders	Africa	ELISA	90	46	38.0	20	6	37.76	Toxoplasma gondii
33	James et al.	2013	2011–2014	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Africa	Rapid Test-Cassette	140	43	28.2	140	25	–	Toxoplasma gondii
34	Juanah et al.	2013	–	Hospitalized	Bipolar and Related Disorder	Asia	ELISA	88	45	–	88	27	–	Toxoplasma gondii
35	khademvatan et al.	2013	2011–2012	Hospitalized	Bipolar and Related Disorder	Asia	ELISA	117	37	33.93	200	53	33.88	Toxoplasma gondii
36	Pearce et al.	2013	–	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	North America	ELISA	183	21	44.9	137	13	37.7	Toxoplasma gondii
37	Hamdani et al.	2013	–	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Europe	ELISA	110	80	44.87	106	41	–	Toxoplasma gondii
38	Khademvatan et al.	2014	2011–2012	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	100	34	36.39	200	53	25.04	Toxoplasma gondii
39	AL-Maamuri et al.	2014	2012–2013	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA & LAT	200	143	–	100	45	–	Toxoplasma gondii
40	Ebadi et al.	2014	2011–2012	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	152	129	32.7	152	93	33.5	Toxoplasma gondii
41	Elsaid et al.	2014	–	Hospitalized/Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Africa	ELISA	300	151	–	300	66	–	Toxoplasma gondii
42	Karabulut et al.	2015	–	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	85	35	41.73	60	26	40.45	Toxoplasma gondii
43	Omar et al.	2015	–	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA & PCR	101	52	41.1	55	10	45.3	Toxoplasma gondii
44	Cong et al.	2015	2011–2013	Non hospitalized	Neurocognitive disorders	Asia	ELISA	445	77	–	445	55	–	Toxoplasma gondii
45	Khattak et al.	2015	2013–2014	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	142	58	8.61	76	12	8.42	Toxoplasma gondii
46	Cevizci et al.	2015	–	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	30	10	–	60	13	–	Toxoplasma gondii
47	Bakre et al.	2015	–	Hospitalized	Neurodevelopmental Disorders	Asia	ELISA & LAT	93	41	–	93	12	–	Toxoplasma gondii
48	Alvarado-Esquivel et al.	2015	2013–2014	Non hospitalized	Neurocognitive disorders	North America	ELISA	149	15	36.01	149	14	36.03	Toxoplasma gondii
49	Esshili et al.	2016	–	Hospitalized	Bipolar and Related Disorder	Africa	ELISA	246	184	40.5	117	63	38.6	Toxoplasma gondii
50	Kheirandish et al.	2016	2015	Non hospitalized	Bipolar and Related Disorder, Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	170	103	–	170	65	–	Toxoplasma gondii
51	Zaki et al.	2016	–	Hospitalized	Neurodevelopmental Disorders	Asia	ELISA	162	58	–	163	24	–	Toxoplasma gondii
52	Menati Rashno et al.	2016	2014–2015	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	87	58	78.17	87	49	45.63	Toxoplasma gondii
53	El-Aal et al.	2016	2015–2016	Non hospitalized	Neurodevelopmental Disorders and Other Psychotic Disorders	Africa	ELISA	230	50	–	60	7	–	Toxoplasma gondii
54	Youssef Saad et al.	2016	2015–2016	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Africa	ELISA & Western Blot	100	52		100	11		Toxoplasma gondii
55	Dalimiasl et al.	2016	–	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	76	42	–	75	27	–	Toxoplasma gondii
56	Abdollahian et al.	2017	2011–2012	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	350	164	35.0	350	120	38.0	Toxoplasma gondii
57	Alvarado-Esquivel et al.	2017	2014	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	North America	ELISA & PCR	65	6	40.3	195	21	40.6	Toxoplasma gondii
58	Ansari-Lari et al.	2017	–	Non hospitalized	Depressive Disorder	Asia	ELISA	99	42	40.3	152	41	40.6	Toxoplasma gondii
59	Bak et al.	2017	2015–2016	Non hospitalized	Obsessive–Compulsive and Related Disorders	Asia	ELISA	155	21	43.75	135	8	41.59	Toxoplasma gondii
60	Akaltun et al.	2017	–	Non hospitalized	Neurocognitive disorders	Asia	ELISA & Sabin-Feldman Dye Test	120	40	–	60	6	–	Toxoplasma gondii
61	Fallahi et al.	2017	–	Non hospitalized	Neurocognitive disorders	Asia	ELISA & PCR	115	61	75.2	115	64	74.1	Toxoplasma gondii
62	Rashno et al.	2017	–	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	87	46	–	87	35	–	Toxoplasma gondii
63	Campos-Carli et al.	2017	–	Non hospitalized	Neurodevelopmental Disorders	South America	ELISA	40	27	40.62	48	32	40.21	Toxoplasma gondii
64	Hamed et al.	2018	2017–2018	Non hospitalized	Neurodevelopmental Disorders	Africa	IHAT	200	84	41.15	200	35	35.58	Toxoplasma gondii
65	Stepanova et al.	2018	2016	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Europe	ELISA	115	62	–	152	39	–	Toxoplasma gondii
66	Muflikhah et al.	2018	2015	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	94	65	–	64	42	–	Toxoplasma gondii
67	Wokem et al.	2018	–	Hospitalized	Bipolar and Related Disorder	Africa	ELISA	200	109	–	200	57	–	Toxoplasma gondii
68	Alvarado-Esquivel	2019	–	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	North America	EIA	66	6	–	396	22	–	Toxoplasma gondii
69	Chen et al.	2019	2016–2018	Hospitalized	Neurodevelopmental Disorders	Asia	ECLIA	798	106	38.83	681	64	37.66	Toxoplasma gondii
70	Fentahun et al.	2019	2018	Hospitalized	Depressive Disorder	Africa	Direct smear & Sedimentation	104	21	14.05	314	49	11.96	Giardia lamblia & Entamoeba histolytica/Entamoeba dispar
71	Sapmaz et al.	2019	2017–2018	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	37	8	15.6	36	2	14.55	Toxoplasma gondii
72	Stepanova et al.	2019	2016	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Europe	ELISA	155	62	–	159	32	–	Toxoplasma gondii
73	Achaw et al.	2019	2018	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Africa	Rapid Test-Cassette	152	53	–	152	31	–	Toxoplasma gondii
74	Alshehri et al.	2019	–	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	30	18	–	20	6	–	Toxoplasma gondii
75	Oana et al.	2019	2011–2012	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Europe	ELISA	91	40	38.7	206	73	48.9	Toxoplasma gondii
76	El-Gebaly et al.	2019	2018	Hospitalized	Depressive Disorder	Africa	ELISA	120	54	–	120	59	–	Toxoplasma gondii
77	Nasirpour et al.	2020	–	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA & PCR	87	53	61.9	87	49	61.9	Toxoplasma gondii
78	Ali et al.	2020	2018–2019	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Africa	ELISA & Western Blot	45	25	39.82	45	13	37.35	Toxoplasma gondii
79	Huseein et al.	2020	2016	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Africa	ELISA	110	57	–	50	15	–	Toxoplasma gondii
80	Kezai et al.	2020	–	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Africa	ELISA	70	49	40.76	70	37	37.97	Toxoplasma gondii
81	Al-Antably et al.	2021	–	Non hospitalized	Depressive Disorder	Africa	ELISA	150	64	–	150	29	–	Toxoplasma gondii
82	Bahceci et al.	2021	–	Non hospitalized	Depressive Disorder, Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	200	72	–	100	21	29.73	Toxoplasma gondii
83	Ekici et al.	2021	2018–2020	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	190	120	–	100	29	–	Toxoplasma gondii
84	Kamal et al.	2021	2017–2019	Non hospitalized	Bipolar and Related Disorder	Africa	Direct smear & Sedimentation & Stain	983	337	36.2	983	105	35.4	Giardia lamblia & Blastocystis hominis &E. histolytica dispar & Entamoeba coli & Cryptosporidium spp & Cyclospora cayetanensis
85	sirin et al.	2021	–	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ECLIA	48	9	–	50	10	–	Toxoplasma gondii
86	Zahariluddin et al.	2021	–	Non hospitalized	Obsessive–Compulsive and Related Disorders	Asia	ELISA	109	26	–	109	35	–	Toxoplasma gondii
87	sirin et al.	2021	2019–2020	Non hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ECLIA	38	6	37.13	48	9	36.08	Toxoplasma gondii
88	Grada et al.	2022	2018–2019	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Europe	ECLIA	308	209	45.64	296	160	45.29	Toxoplasma gondii
89	Liu et al.	2022	2015–2020	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA	3101	94	32.85	2194	23	32.33	Toxoplasma gondii
90	Mohammed	2022	–	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Asia	ELISA & LAT	45	28	–	40	13	–	Toxoplasma gondii
91	Ademe et al.	2022	2018–2019	Hospitalized	Schizophrenia Spectrum and Other Psychotic Disorders	Africa	ECLIA	47	41	29.64	47	38	30.98	Toxoplasma gondii

EIA Enzyme Immunoassay, SFDT Sabin-Feldman Dye Test, ELISA Enzyme-Linked Immunosorbent Assay, CFT Complement fixation test, ELFA Enzyme-linked flourescence assay, IFA Immunofluorescence assay, IHAT Indirect haemagglutination test, ECLIA Electrochemiluminiscence immunoassay, CLIA Chemiluminescent immunoassay

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ISSN: 1757-4749

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