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BMC Infect Dis. 2002; 2: 11.
Published online 2002 July 2. doi: 10.1186/1471-2334-2-11.
PMCID: PMC117239
Increased risk of traffic accidents in subjects with latent toxoplasmosis: a retrospective case-control study
Jaroslav Flegr,corresponding author1 Jan Havlícek,2 Petr Kodym,3 Marek Malý,4 and Zbyněk Smahel5
1Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic
2Research Centrum of Personality and Ethnic Studies, Faculty of Humanities, Charles University, Prague, Czech Republic
3National Reference Laboratory for Toxoplasmosis, National Institute of Public Health, Prague, Czech Republic
4Department of Biostatistics, National Institute of Public Health, Prague, Czech Republic
5Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Prague, Czech Republic
corresponding authorCorresponding author.
Jaroslav Flegr: flegr/at/cesnet.cz; Jan Havlícek: havel/at/natur.cuni.cz; Petr Kodym: kodym/at/szu.cz; Marek Malý: mmaly/at/szu.cz; Zbyněk Smahel: smahel/at/natur.cuni.cz
Received April 19, 2002; Accepted July 2, 2002.
Abstract
Background
The parasite Toxoplasma gondii infects 30–60% of humans worldwide. Latent toxoplasmosis, i.e., the life-long presence of Toxoplasma cysts in neural and muscular tissues, leads to prolongation of reaction times in infected subjects. It is not known, however, whether the changes observed in the laboratory influence the performance of subjects in real-life situations.
Methods
The seroprevalence of latent toxoplasmosis in subjects involved in traffic accidents (N = 146) and in the general population living in the same area (N = 446) was compared by a Mantel-Haenszel test for age-stratified data. Correlation between relative risk of traffic accidents and level of anti-Toxoplasma antibody titre was evaluated with the Cochran-Armitage test for trends.
Results
A higher seroprevalence was found in the traffic accident set than in the general population (Chi2MH = 21.45, p < 0.0001). The value of the odds ratio (OR) suggests that subjects with latent toxoplasmosis had a 2.65 (C.I.95= 1.76–4.01) times higher risk of an accident than the toxoplasmosis-negative subjects. The OR significantly increased with level of anti-Toxoplasma antibody titre (p < 0.0001), being low (OR = 1.86, C.I.95 = 1.14–3.03) for the 99 subjects with low antibody titres (8 and 16), higher (OR = 4.78, C.I.95 = 2.39–9.59) for the 37 subjects with moderate titres (32 and 64), and very high (OR = 16.03, C.I.95 = 1.89–135.66) for the 6 subjects with titres higher than 64.
Conclusion
The subjects with latent toxoplasmosis have significantly increased risk of traffic accidents than the noninfected subjects. Relative risk of traffic accidents decreases with the duration of infection. These results suggest that 'asymptomatic' acquired toxoplasmosis might in fact represent a serious and highly underestimated public health problem, as well as an economic problem.