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Meta-Analysis
. 2017 Jan 13;10(1):27.
doi: 10.1186/s13071-017-1970-6.

A systematic review and meta-analysis of the seroprevalence of Toxoplasma gondii in cats in mainland China

Huan Ding  1   2 , Yu-Meng Gao  1   2 , Yao Deng  1   2 , Poppy H L Lamberton  3   4 , Da-Bing Lu  5   6
Affiliations
Meta-Analysis

A systematic review and meta-analysis of the seroprevalence of Toxoplasma gondii in cats in mainland China

Huan Ding et al. Parasit Vectors. .

Abstract

Background: Toxoplasmosis is caused by Toxoplasma gondii which can infect all warm-blooded animals. As the most common feline definitive host, cats play a vital role in the transmission of T. gondii. However, national estimates of the seroprevalence of T. gondii in cats in mainland China are lacking, and therefore a systematic review and meta-analysis were performed to provide insight into national environmental transmission levels and potential transmission to humans.

Methods: Studies published up until July 1, 2016, on T. gondii seroprevalence in cats within mainland China were searched for in CNKI, WanFang, CBM, PubMed, Embase and through the reference lists of resulting articles. The seroprevalence with its 95% confidence interval (CI) for each individual study was presented, and then point estimates and their 95% confidence intervals (CIs) of pooled seroprevalence were calculated. Subgroup analyses were performed according to potential risk factors.

Results: A total of 38 eligible studies, published between 1995 to 2016, covering fifteen provinces and municipalities, and involving 7,285 cats, were included. The seroprevalence in cats per study ranged from 3.9 to 79.4% with a median of 20.3%. As substantial heterogeneity existed among studies, a random-effects model was used to estimate the pooled seroprevalence. The value of the point estimate seroprevalence was 24.5% (95% CI: 20.1-29.0). Seroprevalence in stray cats was significantly higher than in pet cats (OR = 3.00, 95% CI: 1.60-5.64). The seroprevalence increased significantly with cat age (P = 0.018) with 17.4% (95% CI: 7.6-27.2) in the group of ≤ 1 year old, 19.5% (95% CI: 12.7-26.3) in the group of ≤ 3 year-old and 31.6% (95% CI: 22.9-40.3) in the group of > 3 year-old.

Conclusions: The seroprevalence of T. gondii in cats in mainland China was moderate and was associated with cat ownership and age. Due to the increasing prevalence of pet cats in China and the intimate relationship between these cats and humans, this might present a significant exposure risk, particularly for China's large susceptible population. Therefore, further research is needed into the links between cat ownership and human T. gondii infection and how to reduce T. gondii exposure in humans via cat contacts and the environmental contamination with T. gondii oocysts by cats.

Keywords: Cats; Mainland china; Meta-analysis; Seroprevalence; Toxoplasma gondii.

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Figures

Fig. 1
Fig. 1
Flow diagram of the selection of eligible studies
Fig. 2
Fig. 2
Forest plot of the seroprevalence estimates of T. gondii in cats with random-effects analyses
Fig. 3
Fig. 3
Forest plot of the seroprevalence estimates of T. gondii in cats by stray or pet cats
Fig. 4
Fig. 4
Forest plot of the seroprevalence estimates of T. gondii in cats by age groups (≤ 1 year-old, ≤ 3 year-old or > 3 year-old) with random-effects analyses
Fig. 5
Fig. 5
Funnel plots of the arcsine transformed seroprevalence estimates (t) of T. gondii in cats Abbreviation: se, standard error
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