Association between Toxoplasma gondii infection and headache: a systematic review and meta-analysis

Background: The impact of infectious agents, such as Toxoplasma gondii (T. gondii), on human behavior and mental disorders has recently attracted the attention of researchers. T. gondii has emerged as a suitable candidate for such disorders due to its neural nature. Therefore, the current study aimed at investigating the possible relationship between T. gondii infection and headache.

Methods: Five databases were thoroughly searched (up to October 4, 2019) for articles on the prevalence of T. gondii in headache sufferer. In this study, the odds ratio (OR) and corresponding 95% confidence interval (CI) were estimated using a random effect model and forest plot to gauge effect size and effect of each study.

Results: A total number of four articles, including three case-controls and one cross-sectional studies with 2517 participants entered the meta-analysis out of whom 1205 subjects were afflicted with headache or migraine (17.67% positive for toxoplasmosis) and 1312 participants were not (18.29% for toxoplasmosis). The results of the meta-analysis indicated a common OR of 1.59 (95% CI: 1.03-2.47) by the random effect model.

Conclusion: The obtained results of several studies have linked toxoplasmosis and headache. Therefore, more quality studies with larger sample sizes are needed to determine the detailed association between headache and T. gondii infection for the prevention and control of toxoplasmosis among headache sufferers.

Keywords: Headache; Meta-analysis; Migraine; Systematic review; Toxoplasma gondii; Toxoplasmosis.