Folia Parasitologica 61[6] 485-494 (2014) | DOI: 10.14411/fp.2014.061

Does the prevalence of latent toxoplasmosis and frequency of Rhesus-negative subjects correlate with the nationwide rate of traffic accidents?

Jaroslav Flegr1, Madhukar Dama2
1 Department of Biology, Faculty of Science, Charles University, Prague, Czech Republic;
2 Institute of Wildlife Veterinary Research, KVAFSU, Kodagu, India

Latent toxoplasmosis is probably the most common protistan parasitic disease with many indirect negative impacts on human health. One of the important impacts is impaired psychomotor function leading to reduced driving efficiency in Toxoplasma-seropositive subjects. Numerous case-control studies have established a positive relation between the seroprevalence of Toxoplasma gondii (Nicolle et Manceaux, 1908) and probability of traffic accidents in study populations. The prevalence of toxoplasmosis varies between populations according to local geographical conditions, hygienic practices and kitchen habits. Similarly, we see a striking variation in the incidence of traffic accidents across countries. Hence, we compiled the largest ever data set on the seroprevalence of toxoplasmosis and tried to understand its role in traffic accident-related deaths and disabilities across 87 countries. Simple nonparametric analysis showed a positive and strong relation of T. gondii seroprevalence and traffic accident related disabilities. Further, we conducted multivariate analysis to control for confounding factors. After controlling for wealth, geographical latitude, health of population, length of roads and number of vehicles, the correlation disappeared. When the frequency of RhD negativity and its interaction with toxoplasmosis were included into the model, the effects of toxoplasmosis seemingly returned. However, the analysed data suffered from the problem of multicollinearity. When a proper method of analysis, ridge regression, was applied, the effects of toxoplasmosis prevalence and RhD negativity frequency disappeared again. The existence of a strong correlation between the prevalence of toxoplasmosis and health of population in particular countries, which was the probable cause of multicollinearity and possible reason for the negative result of the present study, suggests that 'asymptomatic' latent toxoplasmosis could have a large impact on public health.

Keywords: parasite, Toxoplasma, manipulation hypothesis, correlation study, ecological regression, Disability Adjusted Life Years

Received: April 23, 2014; Accepted: July 23, 2014; Prepublished online: October 17, 2014; Published: December 4, 2014  Show citation

ACS AIP APA ASA Harvard Chicago IEEE ISO690 MLA NLM Turabian Vancouver
Flegr, J., & Dama, M. (2014). Does the prevalence of latent toxoplasmosis and frequency of Rhesus-negative subjects correlate with the nationwide rate of traffic accidents? Folia Parasitologica61(6), 485-494. doi: 10.14411/fp.2014.061
Download citation

References

  1. Abu-Madi M.A., Behnke J.M., Dabritz H.A. 2010: Toxoplasma gondii seropositivity and co-infection with TORCH pathogens in high-risk patients from Qatar. Am. J. Trop. Med. Hyg. 82: 626-633 Go to original source... Go to PubMed...
  2. Ahmed M.U., Hafiz A. 1997: Toxoplasmosis and abortion: serological correlation. J. Coll. Phys. Surg. Pak. 7: 156-159
  3. Alvarado-Esquivel C., Torres-Castorena A., Liesenfeld O., Estrada-Martinez S., Urbina-Alvarez J.D. 2012: High seroprevalence of Toxoplasma gondii infection in a subset of Mexican patients with work accidents and low socioeconomic status. Parasite Vector. 5: 13 Go to original source... Go to PubMed...
  4. Ancelle T., Goulet V., Tirard-Fleury V. 2003: La toxoplasmose en France chez la femme enceinte en 2003: seroprevalence et facteurs associes. Bull. Epidemiol. Hebd. 51: 227-229
  5. Antoniou M., Tzouvali H., Sifakis S., Galanakis E., Georgopoulou E., Liakou V., Giannakopoulou C., Koumantakis E., Tselentis Y. 2004: Incidence of toxoplasmosis in 5532 pregnant women in Crete, Greece: management of 185 cases at risk. Eur. J. Obstet. Gynecol. Reprod. Biol. 117: 138-143 Go to original source... Go to PubMed...
  6. Arias M.L., Chinchilla M., Reyes L., Linder E. 1996: Seroepidemiology of toxoplasmosis in humans: possible transmission routes in Costa Rica. Rev. Biol. Trop. 44: 377-381 Go to PubMed...
  7. Ashrafunnessa, Shahla K., Islam M.N., Huq T. 1998: Seroprevalence of Toxoplasma antibodies among the antenatal population in Bangladesh. J. Obstet. Gynaecol. Res. 24: 115-119 Go to original source...
  8. Asthana S.P., Macpherson C.N., Weiss S.H., Stephens R., Denny T.N., Sharma R.N., Dubey J.P. 2006: Seroprevalence of Toxoplasma gondii in pregnant women and cats in Grenada, West Indies. J. Parasitol. 92: 644-645 Go to original source... Go to PubMed...
  9. Attia R.A., el-Zayat M.M., Rizk H., Motawea S. 1995: Toxoplasma IgG. & IgM. antibodies. A case control study. J. Egypt. Soc. Parasitol. 25: 877-882
  10. Barber N. 2004: Sex ratio at birth, polygyny, and fertility: a cross-national study. Soc. Biol. 51: 71-77 Go to original source...
  11. Birgisdottir A., Asbjornsdottir H., Cook E., Gislason D., Jansson C., Olafsson I., Gislason T., Jogi R., Thjodleifsson B. 2006: Seroprevalence of Toxoplasma gondii in Sweden, Estonia and Iceland. Scand. J. Infect. Dis. 38: 625-631 Go to original source... Go to PubMed...
  12. Bobic B., Nikolic A., Klun I., Djurkovic-Djakovic O. 2011: Kinetics of Toxoplasma infection in the Balkans. Wien. Klin. Wochenschr. 123: 2-6 Go to original source... Go to PubMed...
  13. Borkakoty B.J., Borthakur A.K., Gohain M. 2007: Prevalence of Toxoplasma gondii infection amongst pregnant women in Assam, India. Ind. J. Med. Microbiol. 25: 431-432 Go to original source... Go to PubMed...
  14. Breugelmans M., Naessens A., Foulon W. 2004: Prevention of toxoplasmosis during pregnancy - an epidemiologic survey over 22 consecutive years. J. Perinat. Med. 32: 211-214 Go to original source... Go to PubMed...
  15. Buchy P., Follezou J.Y., Lien T.X., An T.T., Tram L.T., Tri D.V., Cuong N.M., Glaziou P., Chien B.T. 2003: Etude serologique de la toxoplasmose au Vietnam dans une population de toxicomanes (Ho Chi Minh ville) et de femmes enceintes (Nha Trang). Bull. Soc. Pathol. Exot. Filial. 96: 46-47 Go to PubMed...
  16. Caballero-Ortega H., Uribe-Salas F.J., Conde-Glez C.J., Cedillo-Pelaez C., Vargas-Villavicencio J.A., Luna-Pasten H., Canedo-Solares I., Ortiz-Alegria L.B., Correa D. 2012: Seroprevalence and national distribution of human toxoplasmosis in Mexico: analysis of the 2000 and 2006 National Health Surveys. Trans. R. Soc. Trop. Med. Hyg. 106: 653-659 Go to original source... Go to PubMed...
  17. Cantella R., Colichon A., Lopez L., Wu C., Goldfarb A., Cuadra E., Latorre C., Kanashiro R., Delgado M., Piscoya Z. 1974: Toxoplasmosis in Peru. Geographic prevalence of Toxoplasma gondii antibodies in Peru studied by indirect fluorescent antibody technique. Trop. Geogr. Med. 26: 204-209
  18. Contreras M.C., Schenone H., Salinas P., Sandoval L., Rojas A., Villarroel F., Solis F. 2009: Seroepidemiology of human toxoplasmosis in Chile. Rev. Inst. Med. Trop. Sao Paulo 38: 431-435 Go to original source...
  19. Crucerescu E. 1998: [Epidemiological data on toxoplasmosis. The aspects of congenital toxoplasmosis]. Bacteriol. Virusol. Parazitol. Epidemiol. 43: 147-155. (In Romanian.) Go to PubMed...
  20. Dama M.S. 2012: Parasite stress predicts offspring sex ratio. PLoS ONE 7: e46169 Go to original source... Go to PubMed...
  21. Dar F.K., Alkarmi T., Uduman S., Abdulrazzaq Y., Grundsell H., Hughes P. 1997: Gestational and neonatal toxoplasmosis: regional seroprevalence in the United Arab Emirates. Eur. J. Epidemiol. 13: 567-571 Go to original source... Go to PubMed...
  22. Deniau M., Tourte-Schaefer C., Agbo K., Dupouy-Camet J., Heyer C., Lapierre J. 1991: Evaluation des risques de toxoplasmose congenitale au Togo. Bull. Soc. Pathol. Exot. Filial. 84: 664-672 Go to PubMed...
  23. De Paschale M., Agrappi C., Clerici P., Mirri P., Manco M.T., Cavallari S., Vigano E.F. 2008: Seroprevalence and incidence of Toxoplasma gondii infection in the Legnano area of Italy. Clin. Microbiol. Infec. 14: 186-189 Go to original source...
  24. Doehring E., Reiter-Owona I., Bauer O., Kaisi M., Hlobil H., Quade G., Hamudu N.A., Seitz H.M. 1995: Toxoplasma gondii antibodies in pregnant women and their newborns in Dar es Salaam, Tanzania. Am. J. Trop. Med. Hyg. 52: 546-548 Go to original source... Go to PubMed...
  25. Dubey J.P., Tiao N., Gebreyes W.A., Jones J.L. 2012: A review of toxoplasmosis in humans and animals in Ethiopia. Epidemiol. Infect. 140: 1935-1938 Go to original source... Go to PubMed...
  26. El Mansouri B., Rhajaoui M., Sebti F., Amarir F., Laboudi M., Bchitou R., Hamad M., Lyagoubi M. 2007: Seroprevalence de la toxoplasmose chez la femme enceinte dans la ville de Rabat au Maroc. Bull. Soc. Pathol. Exot. Filial. 100: 289-290 Go to PubMed...
  27. Elnahas A., Gerais A.S., Elbashir M.I., Eldien E.S., Adam I. 2003: Toxoplasmosis in pregnant Sudanese women. Saudi Med. J. 24: 868-870 Go to PubMed...
  28. Evengard B., Petersson K., Engman M.L., Wiklund S., Ivarsson S.A., Tear-Fahnehjelm K., Forsgren M., Gilbert R., Malm G. 2001: Low incidence of Toxoplasma infection during pregnancy and in newborns in Sweden. Epidemiol. Infect. 127: 121-127 Go to original source... Go to PubMed...
  29. Fallah M., Rabiee S., Matini M., Taherkhani H. 2008: Seroepidemiology of toxoplasmosis in primigravida women in Hamadan, Islamic Republic of Iran, 2004. East. Mediterr. Hlth J. 14: 163-171
  30. Faye O., Leye A., Dieng Y., Richard-Lenoble D., Diallo S. 1998: La toxoplasmose a Dakar. Sondage seroepidemiologique chez 353 femmes en age de procreer. Bull. Soc. Pathol. Exot. Filial. 91: 249-250 Go to PubMed...
  31. Ferguson W., Mayne P.D., Lennon B., Butler K., Cafferkey M. 2008: Susceptibility of pregnant women to Toxoplasma infection - potential benefits for newborn screening. Ir. Med. J. 101: 220-221 Go to PubMed...
  32. Fiedler K., Hulsse C., Straube W., Briese V. 1999: Toxoplasmose-Durchseuchungsstudie in Mecklenburg-Vorpommern. Zentralbl. Gynakol. 121: 239-243 Go to PubMed...
  33. Flegr J., Geryk J., Volny J., Klose J., Cernochova D. 2012: Rhesus factor modulation of effects of smoking and age on psychomotor performance, intelligence, personality profile, and health in Czech soldiers. PLoS ONE 7: e49478 Go to original source... Go to PubMed...
  34. Flegr J., Havlicek J., Kodym P., Maly M., Smahel Z. 2002: Increased risk of traffic accidents in subjects with latent toxoplasmosis: a retrospective case-control study. BMC Infect. Dis. 2: 11 Go to original source... Go to PubMed...
  35. Flegr J., Hrdy I. 1994: Influence of chronic toxoplasmosis on some human personality factors. Folia Parasitol. 41: 122-126 Go to PubMed...
  36. Flegr J., Klose J., Novotna M., Berenreitterova M., Havlicek J. 2009: Increased incidence of traffic accidents in Toxoplasma-infected military drivers and protective effect RhD molecule revealed by a large-scale prospective cohort study. BMC Infect. Dis. 9: 72 Go to original source... Go to PubMed...
  37. Flegr J., Lindova J., Kodym P. 2008b: Sex-dependent toxoplasmosis-associated differences in testosterone concentration in humans. Parasitology 135: 427-431 Go to original source... Go to PubMed...
  38. Flegr J., Lindova J., Pivonkova V., Havlicek J. 2008c: Brief communication: latent toxoplasmosis and salivary testosterone concentration - important confounding factors in second to fourth digit ratio studies. Am. J. Phys. Anthropol. 137: 479-484 Go to original source... Go to PubMed...
  39. Flegr J., Novotna M., Fialova A., Kolbekova P., Gasova Z. 2010: The influence of RhD phenotype on toxoplasmosis- and age-associated changes in personality profile of blood donors. Folia Parasitol. 57: 143-150 Go to original source... Go to PubMed...
  40. Flegr J., Novotna M., Lindova J., Havlicek J. 2008a: Neurophysiological effect of the Rh factor. Protective role of the RhD molecule against Toxoplasma-induced impairment of reaction times in women. Neuroendocrinol. Lett. 29: 475-481 Go to PubMed...
  41. Flegr J., Prandota J., Sovickova M., Israili Z.H. 2014: Toxoplasmosis - a global threat. Correlation of latent toxoplasmosis with specific disease burden in a set of 88 countries. PLoS ONE 9: e90203 Go to original source... Go to PubMed...
  42. Flegr J., Zitkova S., Kodym P., Frynta D. 1996: Induction of changes in human behaviour by the parasitic protozoan Toxoplasma gondii. Parasitology 113: 49-54 Go to original source... Go to PubMed...
  43. Fonseca A.L., Silva R.A., Fux B., Madureira A.P., de Sousa F.F., Margonari C. 2012: Epidemiologic aspects of toxoplasmosis and evaluation of its seroprevalence in pregnant women. Rev. Soc. Bras. Med. Trop. 45: 357-364 Go to original source... Go to PubMed...
  44. Franklin D.M., Dror Z., Nishri Z. 1993: The prevalence and incidence of Toxoplasma antibodies in pregnant women. Isr. J. Med. Sci. 29: 285-286
  45. Galvan-Ramirez M.D., Sanchez-Orozco L.V., Rodriguez L.R., Rodriguez S., Roig-Melo E., Sanroman R.T., Chiquete E., Armendariz-Borunda J. 2013: Seroepidemiology of Toxoplasma gondii infection in drivers involved in road traffic accidents in the metropolitan area of Guadalajara, Jalisco, Mexico. Parasite Vector. 6: 294 Go to original source... Go to PubMed...
  46. el Hady H.M. 1991: Toxoplasmosis among pregnant women in Abha, Saudi Arabia. J. Egypt. Soc. Parasitol. 21: 811-815
  47. Harma M., Gungen N., Demir N. 2004: Toxoplasmosis in pregnant women in Sanliurfa, Southeastern Anatolia City, Turkey. J. Egypt. Soc. Parasitol. 34: 519-525
  48. Havlicek J., Gasova Z., Smith A.P., Zvara K., Flegr J. 2001: Decrease of psychomotor performance in subjects with latent 'asymptomatic' toxoplasmosis. Parasitology 122: 515-520 Go to original source... Go to PubMed...
  49. Hung C.C., Fan C.K., Su K.E., Sung F.C., Chiou H.Y., Gil V., da Conceicao dos Reis Ferreira M., de Carvalho J.M., Cruz C., Lin Y.K., Tseng L.F., Sao K.Y., Chang W.C., Lan H.S., Chou S.H. 2007: Serological screening and toxoplasmosis exposure factors among pregnant women in the Democratic Republic of Sao Tome and Principe. Trans. R. Soc. Trop. Med. Hyg. 101: 134-139 Go to original source... Go to PubMed...
  50. Iqbal J., Hira P.R., Khalid N. 2003: Toxoplasmosis in Kuwait: improved diagnosis based on quantitative immuno-assay. Clin. Microbiol. Infect 9: 336
  51. Jenum P.A., Kapperud G., Stray-Pedersen B., Melby K.K., Eskild A., Eng J. 1998: Prevalence of Toxoplasma gondii specific immunoglobulin G antibodies among pregnant women in Norway. Epidemiol. Infect. 120: 87-92 Go to original source... Go to PubMed...
  52. Jones J.L., Kruszon-Moran D., Sanders-Lewis K., Wilson M. 2007: Toxoplasma gondii infection in the United States, 1999-2004, decline from the prior decade. Am. J. Trop. Med. Hyg. 77: 405-410 Go to original source... Go to PubMed...
  53. Jumaian N.F. 2005: Seroprevalence and risk factors for Toxoplasma infection in pregnant women in Jordan. East. Mediterr. Hlth J. 11: 45-51
  54. Kankova S., Flegr J. 2007: Longer pregnancy and slower fetal development in women with latent "asymptomatic" toxoplasmosis. BMC Infect. Dis. 7: 114 Go to original source... Go to PubMed...
  55. Karunajeewa H., Siebert D., Hammond R., Garland S., Kelly H. 2001: Seroprevalence of varicella zoster virus, parvovirus B19 and Toxoplasma gondii in a Melbourne obstetric population: implications for management. Aust. N. Z. J. Obstet. Gynaecol. 41: 23-28 Go to original source... Go to PubMed...
  56. Klufio C.A., Delamare O., Amoa A.B., Kariwiga G. 1993: The prevalence of Toxoplasma antibodies in pregnant patients attending the Port Moresby General Hospital antenatal clinic: a seroepidemiological survey. Papua New Guinea Med. J. 36: 4-9
  57. Kocazeybek B., Oner Y.A., Turksoy R., Babur C., Cakan H., Sahip N., Unal A., Ozaslan A., Kilic S., Saribas S., Asian M., Taylan A., Koc S., Dirican A., Uner H.B., Oz V., Ertekin C., Kucukbasmaci O., Torun M.M. 2009: Higher prevalence of toxoplasmosis in victims of traffic accidents suggest increased risk of traffic accident in Toxoplasma-infected inhabitants of Istanbul and its suburbs. Forensic Sci. Int. 187: 103-108 Go to original source... Go to PubMed...
  58. Konishi E., Houki Y., Harano K., Mibawani R.S., Marsudi D., Alibasah S., Dachlan Y.P. 2000: High prevalence of antibody to Toxoplasma gondii among humans in Surabaya, Indonesia. Jpn. J. Infect. Dis. 53: 238-241
  59. Kortbeek L.M., De Melker H.E., Veldhuijzen I.K., Conyn-Van Spaendonck M.A. 2004: Population-based Toxoplasma seroprevalence study in The Netherlands. Epidemiol. Infect. 132: 839-845 Go to original source... Go to PubMed...
  60. Koskiniemi M., Lappalainen M., Koskela P., Hedman K., Ammala P., Hiilesmaa V., Teramo K. 1992: The program for antenatal screening of toxoplasmosis in Finland: a prospective cohort study. Scand. J. Infect. Dis. Suppl. 84: 70-74
  61. Lafferty K.D. 2006: Can the common brain parasite, Toxoplasma gondii, influence human culture? Proc. R. Soc. Biol. Sci. Ser. B 273: 2749-2755 Go to original source... Go to PubMed...
  62. Lebech M., Andersen O., Christensen N.C., Hertel J., Nielsen H.E., Peitersen B., Rechnitzer C., Larsen S.O., Norgaard-Pedersen B., Petersen E. 1999: Feasibility of neonatal screening for Toxoplasma infection in the absence of prenatal treatment. Lancet 353: 1834-1837 Go to original source... Go to PubMed...
  63. Lelong B., Rahelimino B., Candolfi E., Ravelojaona B.J., Villard O., Rasamindrakotroka A.J., Kien T. 1995: Prevalence of toxoplasmosis in a population of pregnant women in Antananarivo (Madagascar). Bull. Soc. Pathol. Exot. Filial. 88: 46-49 Go to PubMed...
  64. Lim H., Lee S.E., Jung B.K., Kim M.K., Lee M.Y., Nam H.W., Shin J.G., Yun C.H., Cho H.I., Shin E.H., Chai J.Y. 2012: Serologic survey of toxoplasmosis in Seoul and Jeju-do, and a brief review of its seroprevalence in Korea. Kor. J. Parasitol. 50: 287-293 Go to original source... Go to PubMed...
  65. Lindova J., Priplatova L., Flegr J. 2012: Higher extraversion and lower conscientiousness in humans infected with Toxoplasma. Eur. J. Person. 26: 285-291 Go to original source...
  66. Liu Q., Wei F., Gao S.Y., Jiang L., Lian H., Yuan B., Yuan Z.G., Xia Z.P., Liu B., Xu X.H., Zhu X.Q. 2009: Toxoplasma gondii infection in pregnant women in China. Trans. R. Soc. Trop. Med. Hyg. 103: 162-166 Go to original source... Go to PubMed...
  67. Logar J., Petrovec M., Novak-Antolic Z., Premru-Srsen T., Cizman M., Arnez M., Kraut A. 2002: Prevention of congenital toxoplasmosis in Slovenia by serological screening of pregnant women. Scand. J. Infect. Dis. 34: 201-204 Go to original source... Go to PubMed...
  68. Lopes A.P., Dubey J.P., Moutinho O., Gargate M.J., Vilares A., Rodrigues M., Cardoso L. 2012: Seroepidemiology of Toxoplasma gondii infection in women from the North of Portugal in their childbearing years. Epidemiol. Infect. 140: 872-877 Go to original source... Go to PubMed...
  69. Lopez A.D., Mathers C.D., Ezati M., Jamison D.T., Murray, C.J.L. 2006. Global Burden of Disease and Risk Factors. Washington (DC), World Bank, 736 pp Go to original source...
  70. Maggi P., Volpe A., Carito V., Schinaia N., Bino S., Basho M., Dentico P. 2009: Surveillance of toxoplasmosis in pregnant women in Albania. New Microbiol. 32: 89-92 Go to PubMed...
  71. Mahdi N.K., Sharief M. 2002: Risk factors for acquiring toxoplasmosis in pregnancy. J. Bahrain Med. Soc. 14: 148-151
  72. Makuwa M., Lecko M., Nsimba B., Bakouetela J., Lounana-Kouta J. 1992: Toxoplasmose et al femme enceinte au Congo. Bilan de 5 ans de depistage (1986-1990). Med. Afr. Noire 39: 493-495
  73. Many A., Koren G. 2006: Toxoplasmosis during pregnancy. Can. Fam. Physician 52: 29-30, 32
  74. Moese J.R., Vander-Moese A. 1998: Mother-child pass in Austria and primary toxoplasmosis infections in pregnant women. Centr. Eur. J. Publ. Hlth. 6: 261-264
  75. Morris A., Croxson M. 2004: Serological evidence of Toxoplasma gondii infection among pregnant women in Auckland. N. Z. Med. J. 117: U770 Go to PubMed...
  76. Mourant A.E. 1954: The Distribution of the Human Blood Groups. Blackwell Scientific Publication, Oxford, 438 pp
  77. Mousa D.A., Mohammad M.A., Toboli A.B. 2011: Toxoplasma gondii infection in pregnant women with previous adverse pregnancy outcome. Med. J. Islam. World Acad. Sci. 19: 95-102
  78. Munoz Batet C., Guardia Llobet C., Juncosa Morros T., Vinas Domenech L., Sierra Soler M., Sanfeliu Sala I., Bosch Mestres J., Dopico Ponte E., Lite Lite J., Matas Andreu L., Juste Sanchez C., Barranco Romeu M. 2004: Toxoplasmosis y embarazo. Estudio multicentrico realizado en 16.362 gestantes de Barcelona. Med. Clin. 123: 12-16 Go to original source... Go to PubMed...
  79. Nabias R., Ngouamizokou A., Migot-Nabias F., Mbou-Moutsimbi R.A., Lansoud-Soukate J. 1998: Enquete serologique sur la toxoplasmose chez les consultantes du centre de P.M.I. de Franceville (Gabon). Bull. Soc. Pathol. Exot. Filial. 91: 318-320 Go to PubMed...
  80. Nash J.Q., Chissel S., Jones J., Warburton F., Verlander N.Q. 2005: Risk factors for toxoplasmosis in pregnant women in Kent, United Kingdom. Epidemiol. Infect. 133: 475-483 Go to original source... Go to PubMed...
  81. Ndong-Obame T., Ayadi A. 1997: La toxoplasmose acquise et congenitale dans la region de Sfax (Tunisie). Bull. Soc. Fr. Parasitol. 15: 141-147
  82. Ndumbe P.M., Andela A., Nkemnkengasong J., Watonsi E., Nyambi P. 1992: Prevalence of infections affecting the child among pregnant women in Yaounde, Cameroon. Med. Microbiol. Immunol. 181: 127-130 Go to original source...
  83. Nissapatorn V., Noor Azmi M.A., Cho S.M., Fong M.Y., Init I., Rohela M., Khairul Anuar A., Quek K.F., Latt H.M. 2003: Toxoplasmosis: prevalence and risk factors. J. Obstet. Gynaecol. 23: 618-624 Go to original source... Go to PubMed...
  84. Novotna M., Havlicek J., Smith A.P., Kolbekova P., Skallova A., Klose J., Gasova Z., Pisacka M., Sechovska M., Flegr J. 2008: Toxoplasma and reaction time: role of toxoplasmosis in the origin, preservation and geographical distribution of Rh blood group polymorphism. Parasitology 135: 1253-1261 Go to original source... Go to PubMed...
  85. Nowakowska D., Stray-Pedersen B., Spiewak E., Sobala W., Malafiej E., Wilczynski J. 2006: Prevalence and estimated incidence of Toxoplasma infection among pregnant women in Poland: a decreasing trend in the younger population. Clin. Microbiol. Infec. 12: 913-917 Go to original source... Go to PubMed...
  86. Onadeko M.O., Joynson D.H., Payne R.A. 1992: The prevalence of Toxoplasma infection among pregnant women in Ibadan, Nigeria. J. Trop. Med. Hyg. 95: 143-145
  87. Pappas G., Roussos N., Falagas M.E. 2009: Toxoplasmosis snapshots: global status of Toxoplasma gondii seroprevalence and implications for pregnancy and congenital toxoplasmosis. Int. J. Parasitol. 39: 1385-1394 Go to original source... Go to PubMed...
  88. Pearce B.D., Hubbard S., Rivera H.N., Wilkins P.P., Fisch M.C., Hopkins M.H., Hasenkamp W., Gross R., Bliwise N., Jones J.L., Duncan E. 2013: Toxoplasma gondii exposure affects neural processing speed as measured by acoustic startle latency in schizophrenia and controls. Schizophr. Res. 150: 258-261 Go to original source... Go to PubMed...
  89. Pedersen M.G., Mortensen P.B., Norgaard-Pedersen B., Postolache T.T. 2012: Toxoplasma gondii infection and self-directed violence in mothers. Arch. Gen. Psychiatry 69: 1123-1130 Go to original source... Go to PubMed...
  90. Prabhakar P., Bailey A., Smikle M.F., McCaw-Binns A., Ashley D. 1991: Seroprevalence of Toxoplasma gondii, rubella virus, cytomegalovirus herpes simplex virus (TORCH) and syphilis in Jamaican pregnant women. West Ind. Med. J. 40: 166-169
  91. Prandota J. 2012: Rhesus-associated glycoprotein (RhAG) phenotype of the red blood cells modulates T. gondii infection-associated psychomotor performance reaction times and changes in the human personality profile. Impaired function of the CO2, AQP1, and AQP4 gas channels may cause hypoxia and thus enhance neuroinflammation in autistic individuals. In: C. Gemma (Ed.), Neuroinflammation: Pathogenesis, Mechanisms and Management. Nova Publishers, New York, pp. 423-439
  92. Punda-Polic V., Tonkic M., Capkun V. 2000: Prevalence of antibodies to Toxoplasma gondii in the female population of the County of Split, Dalmatia, Croatia. Eur. J. Epidemiol. 16: 875-877 Go to original source... Go to PubMed...
  93. Rai S.K., Shibata H., Sumi K., Rai G., Rai N., Manandhar R., Gurung G., Ono K., Uga S., Matsuoka A., Shrestha H.G., Matsumura T. 1998: Toxoplasma antibody prevalence in Nepalese pregnant women and women with bad obstetric history. Southeast Asian J. Trop. Med. Publ. Hlth. 29: 739-743
  94. Ramsewak S., Gooding R., Ganta K., Seepersadsingh N., Adesiyun A.A. 2008: Seroprevalence and risk factors of Toxoplasma gondii infection among pregnant women in Trinidad and Tobago. Rev. Panam. Salud Publ. 23: 164-170 Go to original source... Go to PubMed...
  95. Rickard E., Costagliola M., Outen E., Cicero M., Garcia G., Dieguez N., Pendiveni M. 1999: Toxoplasmosis antibody prevalence in pregnancy in Buenos Aires Province, Argentina. Clin. Microbiol. Infec. 5 171-172
  96. Rockiene L. 1997: The prognosis of congenital toxoplasmosis in Lithuania. Hygiena Epidemiol. 58: 39-45
  97. Rodier M.H., Berthonneau J., Bourgoin A., Giraudeau G., Agius G., Burucoa C., Hekpazo A., Jacquemin J.L. 1995: Seroprevalences of Toxoplasma, malaria, rubella, cytomegalovirus, HIV and treponemal infections among pregnant women in Cotonou, Republic of Benin. Acta Trop. 59: 271-277 Go to original source... Go to PubMed...
  98. Rosso F., Les J.T., Agudelo A., Villalobos C., Chaves J.A., Tunubala G.A., Messa A., Remington J.S., Montoya J.G. 2008: Prevalence of infection with Toxoplasma gondii among pregnant women in Cali, Colombia, South America. Am. J. Trop. Med. Hyg. 78: 504-508 Go to original source... Go to PubMed...
  99. Sakikawa M., Noda S., Hanaoka M., Nakayama H., Hojo S., Kakinoki S., Nakata M., Yasuda T., Ikenoue T., Kojima T. 2012: Anti-Toxoplasma antibody prevalence, primary infection rate, and risk factors in a study of toxoplasmosis in 4,466 pregnant women in Japan. Clin. Vaccin. Immunol. 19: 365-367 Go to original source... Go to PubMed...
  100. Sanchez-Gutierrez A., Martin-Hernandez I., Garcia-Izquierdo S.M. 2003: Estudio de reactividad a Toxoplasma gondii en embarazadas de las provincias Ciudad de la Habana y Pinar del Rio, Cuba. Lab. Enferm. Infec. 28: 3-8
  101. Signorell L.M., Seitz D., Merkel S., Berger R., Rudin C. 2006: Cord blood screening for congenital toxoplasmosis in northwestern Switzerland, 1982-1999. Pediatr. Infect. Dis. J. 25: 123-128 Go to original source... Go to PubMed...
  102. Simpore J., Savadogo A., Ilboudo D., Nadambega M.C., Esposito M., Yara J., Pignatelli S., Pietra V., Musumeci S. 2006: Toxoplasma gondii, HCV, and HBV seroprevalence and co-infection among HIV-positive and -negative pregnant women in Burkina Faso. J. Med. Virol. 78: 730-733 Go to original source... Go to PubMed...
  103. Sitoe S.P., Rafael B., Meireles L.R., Andrade H.F., Jr., Thompson R. 2010: Preliminary report of HIV and Toxoplasma gondii occurrence in pregnant women from Mozambique. Rev. Inst. Med. Trop. Sao Paulo 52: 291-295 Go to original source... Go to PubMed...
  104. Stommel E.W., Seguin R., Thadani V.M., Schwartzman J.D., Gilbert K., Ryan K.A., Tosteson T.D., Kasper L.H
  105. 2001: Cryptogenic epilepsy: an infectious etiology? Epilepsia 42: 436-438 Go to PubMed...
  106. Studenicova C., Ondriska F., Holkova R. 2008: [Seroprevalence of Toxoplasma gondii among pregnant women in Slovakia]. Epidemiol. Mikrobiol. Imunol. 57: 8-13. (In Slovak.) Go to PubMed...
  107. Szenasi Z., Horvath K., Sarkany E., Melles M. 2005: Toxoplasmosis surveillance during pregnancy and quality assurance of methods in Hungary. Wien. Klin. Wochenschr. 117: 29-34 Go to original source... Go to PubMed...
  108. Szenasi Z., Ozsvar Z., Nagy E., Jeszenszky M., Szabo J., Gellen J., Vegh M., Verhofstede C. 1997: Prevention of congenital toxoplasmosis in Szeged, Hungary. Int. J. Epidemiol. 26: 428-435 Go to original source... Go to PubMed...
  109. Tabbara K.S., Saleh F. 2005: Serodiagnosis of toxoplasmosis in Bahrain. Saudi Med. J. 26: 1383-1387 Go to PubMed...
  110. Tenter A.M., Heckeroth A.R., Weiss L.M. 2000: Toxoplasma gondii: from animals to humans. Int. J. Parasitol. 30: 1217-1258 Go to original source... Go to PubMed...
  111. Thomas F., Lafferty K.D., Brodeur J., Elguero E., Gauthier-Clerc M., Misse D. 2012: Incidence of adult brain cancers is higher in countries where the protozoan parasite Toxoplasma gondii is common. Biol. Lett. 8: 101-103 Go to original source... Go to PubMed...
  112. Torrey E.F., Bartko J.J., Yolken R.H. 2012: Toxoplasma gondii and other risk factors for schizophrenia: an update. Schizophr. Bull. 38: 642-647 Go to original source... Go to PubMed...
  113. Torrey E.F., Yolken R.H. 1995: Could schizophrenia be a viral zoonosis transmitted from house cats. Schizophr. Bull. 21: 167-171 Go to original source... Go to PubMed...
  114. Triolo-Mieses M., Traviezo-Valles L. 2006: Serological prevalence of Toxoplasma gondii antibodies in pregnancy in Palavecino Municipality Lara State, Venezuela. Kasmera 34: 7-13
  115. WHO 2008: The Global Burden of Disease: 2004 Update. World Health Organization, Geneva, 160 pp
  116. Wong A., Tan K.H., Tee C.S., Yeo G.S. 2000: Seroprevalence of cytomegalovirus, Toxoplasma and parvovirus in pregnancy. Singapore Med. J. 41: 151-155 Go to PubMed...
  117. Yereli K., Balcioglu I.C., Ozbilgin A. 2006: Is Toxoplasma gondii a potential risk for traffic accidents in Turkey? Forensic Sci. Int. 163: 34-37 Go to original source... Go to PubMed...