The global prevalence and risk factors of Toxoplasma gondii among foxes: A systematic review and meta-analysis

Toxoplasma gondii is one of the most successful intracellular protozoan parasites in the world, which can infect most warm-blooded animals including foxes in the world and cause toxoplasmosis. This is the first meta-analysis to assess the overall prevalence and potential risk factors of T. gondii among foxes in the world. Relevant studies were comprehensively collected from ScienceDirect, Springer-Link, PubMed, VIP Chinese Journal Databases (VIP), WanFang, and China National Knowledge Infrastructure (CNKI) databases. The random-effect model was used to calculate pooled prevalence with 95% confidence intervals (CI) and analyzed data were from 20 countries. The pooled T. gondii prevalence in foxes was estimated to be 39.6%. T. gondii has the highest prevalence in North America (51.2%), and lowest in Asia (8.3%). The prevalence in the sub-group after 2006 (44.7%) was lower than 2006 or before (48.5%). The prevalence in female foxes was 46.1%, which was higher than that in male foxes (19.7%). In species subgroup, red fox has the highest prevalence (46.8%). Wild foxes have a higher rate of infection (40.8%) than captive foxes (8.4%). Genotype II of T. gondii is the most prevalent in foxes. We also evaluated the effects of geographical and climate variables on pooled prevalence of T. gondii in foxes. Our research indicated that toxoplasmosis widely existed in the world. The investigation of T. gondii infection in wild animals can provide an estimate of environmental pollution and T. gondii circulation in the ecosystem. It is essential for us to prevent and control T. gondii infection in foxes in order to reduce the risk of human infection.