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Gregory Milne: Toxoplasma gondii: An Underestimated Threat?

The apicomplexan protozoan parasite Toxoplasma gondii has traditionally been thought to be relevant for public health principally with regards to congenital toxoplasmosis and acute postnatally acquired infections in immunocompromised individuals. However, the last few decades have highlighted a potentially substantial burden of human neuropsychiatric disease associated with latent T. gondii infection, including some cases of schizophrenia.

In this Opinion article, we collated epidemiological data from the literature on the association between T. gondii infection and a range of human conditions, from addiction to epilepsy and beyond (15 systematic review citing n=202 datasets collected in 39 countries).

We calculate that globally each year, under the assumption of complete causality, T. gondii infection might be responsible for 150,000–335,000 cases of schizophrenia, 2.1–10.2 million non-fatal traffic accidents and 0.5–9.1 million non-fatal suicide attempts. By comparison, the burden of congenital disease is estimated to be 179,000–206,000 per year.

The collated data therefore suggest that the burden of T. gondii may be greatly underestimated. We discuss potential causative mechanisms, including the parasite’s neurotropic activity and influence on host neurotransmission, and discuss future research, including epidemiological and basic science studies, that will be required to shed further light on the effect of T. gondii on human hosts

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