Toxoplasmosis associated with Down syndrome: A global meta-analytic exploration of elevated infection risk and immune dysfunction

Basirpour, Bahareh; Gholami, Sara; Esboei, Bahman R; Sarvi, Shahabeddin; Gholami, Shirzad; Tork, Mostafa; Sadeghi, Mitra; Daryani, Ahmad; Hosseini, Seyed A; Aghayan, Sargis. A

doi:10.21608/puj.2025.402069.1306

Toxoplasmosis associated with Down syndrome: A global meta-analytic exploration of elevated infection risk and immune dysfunction

Document Type : Review Article

Authors

¹ Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

² Toxoplasmosis Research Center, Department of Parasitology, Mazandaran University of Medical Sciences, Sari, Iran

³ Toxoplasmosis Research Center, Communicable Diseases Institute, Department of Parasitology, Mazandaran University of Medical Sciences, Sari, Iran

⁴ Laboratory of Molecular Parasitology, Scientific Center of Zooloy and Hydroecology, NASRA, 7P. Sevak st. Yerevan 0014, Republic of Armenia

10.21608/puj.2025.402069.1306

Abstract

Down syndrome (DS) is a genetic condition marked by the presence of an additional copy of chromosome 21, often associated with intellectual disability and other neurologic disorders. Patients with DS exhibit heightened susceptibility to infectious diseases, including toxoplasmosis, attributable to immune dysregulation, and anatomical variations. This systematic review screened existing evidence to evaluate prevalence and the potential association between toxoplasmosis and DS. Following the PRISMA guidelines, an electronic search was conducted across major databases such as PubMed, Web of Science, ScienceDirect, Scopus, EMBASE, and Google Scholar, up to May 2025. The search strategy aimed to identify all relevant studies on T. gondii and DS. The pooled prevalence of T. gondii seropositivity among DS patients, as well as the pooled odds ratio, was calculated using the random-effects model in StatsDirect software. The present review underscores a significant epidemiological signal warranting heightened clinical awareness.

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