151
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Alvarado-Esquivel C, Hernandez-Tinoco J, Sanchez-Anguiano LF. Seroepidemiology of Toxocara infection in patients with vision impairment and blindness in durango, Mexico. J Clin Med Res 2014; 7:176-81. [PMID: 25584103 PMCID: PMC4285064 DOI: 10.14740/jocmr2032w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2014] [Indexed: 11/18/2022] Open
Abstract
Background Toxocara infection is a cause of vision impairment and blindness. We aimed to determine the seroprevalence and correlates of Toxocara infection in patients suffering from vision impairment and blindness in Durango City, Mexico. Methods Through a cross-sectional seroprevalence study, 204 patients with vision impairment and 19 blind patients were studied for the presence of anti-Toxocara IgG antibodies in Durango City, Mexico. Seroprevalence association with socio-demographic, housing, clinical, and behavioral characteristics of participants was also investigated. Results Five (2.5%) of the 204 patients with vision impairment, and none of the 19 patients with blindness were positive for anti-Toxocara IgG antibodies. In total, five of the 223 (2.2%) patients were positive for anti-Toxocara IgG antibodies. Seropositivity to Toxocara was not associated with age, sex, educational level, socio-economic status, presence of underlying diseases or behavioral characteristics of the patients. In contrast, multivariate analysis showed that Toxocara seropositivity was associated with living in a house with soil floor (odds ratio (OR) = 11.14; 95% confidence interval (CI): 1.57 - 78.74; P = 0.01). Conclusions This is the first report of Toxocara exposure in patients with vision impairment and blindness in Mexico, and of an association of Toxocara exposure with living in a house with soil floors. Results suggest a low Toxocara exposure in these patients in Durango, Mexico. The risk factor associated with Toxocara exposure identified in this study warrants for further investigation.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Jesus Hernandez-Tinoco
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Luis Francisco Sanchez-Anguiano
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
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152
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Alvarado-Esquivel C, Hernández-Tinoco J, Sánchez-Anguiano LF, Cisneros-Martínez JA. Low seroprevalence of Toxocara infection in schizophrenic inpatients in durango, Mexico: a case control study. INTERNATIONAL JOURNAL OF BIOMEDICAL SCIENCE : IJBS 2014; 10:269-71. [PMID: 25598759 PMCID: PMC4289702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 10/14/2014] [Indexed: 11/30/2022]
Abstract
Psychiatric patients have a higher seroprevalence of toxocariasis than general population. However, there is poor knowledge about any specific psychiatric diagnosis associated with toxocariasis. The aim of the study was to determine whether seropositivity to Toxocara was associated with schizophrenia. Through an age and gender-matched case-control seroprevalence study in Durango City, Mexico, 50 schizophrenic inpatients in a public psychiatric hospital and 100 control subjects of the general population were compared for the presence of anti-Toxocara IgG antibodies. One of the 50 (2%) schizophrenic inpatients, and 3 (3%) of the 100 controls were positive for anti-Toxocara IgG antibodies. No statistically significant difference in Toxocara seroprevalence among cases and controls was found (P=0.59). The Toxocara positive schizophrenic patient suffered from paranoid schizophrenia (F20.0) and had a number of putative risk factors for Toxocara exposure including contact with cats, dogs and other animals, worked in agriculture, and consumed undercooked meat, unwashed fruits and vegetables, and untreated water. Results suggest that seroprevalence of Toxocara infection was low and not associated with schizophrenia in psychiatric inpatients in Durango, Mexico. However, further studies to elucidate the association of toxocariasis with schizophrenia are needed.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango, Mexico
| | - Jesús Hernández-Tinoco
- Institute for Scientific Research, Juárez University of Durango State, Avenida Universidad S/N. 34000 Durango, Dgo. Mexico
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153
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Sick C, Hennerici MG. Expect the unexpected: a case of isolated eosinophilic meningitis in toxocariasis. Case Rep Neurol 2014; 6:259-63. [PMID: 25535488 PMCID: PMC4265852 DOI: 10.1159/000369060] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We present the case of a young police officer suffering from headache without other neurological symptoms caused by isolated eosinophilic meningitis, which resulted from an infection with Toxocara cati, along with a discussion of the differential diagnosis.
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Affiliation(s)
- Christian Sick
- Department of Neurology, University Hospital Mannheim, Mannheim, Germany
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154
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Auer H, Aspöck H. Helminths and helminthoses in Central Europe: diseases caused by nematodes (roundworms). Wien Med Wochenschr 2014; 164:424-34. [DOI: 10.1007/s10354-014-0317-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 09/16/2014] [Indexed: 11/28/2022]
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155
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Seong S, Moon D, Lee DK, Kim HE, Oh HS, Kim SH, Kwon OW, You YS. A case of ocular toxocariasis successfully treated with albendazole and triamcinolon. THE KOREAN JOURNAL OF PARASITOLOGY 2014; 52:537-40. [PMID: 25352704 PMCID: PMC4210738 DOI: 10.3347/kjp.2014.52.5.537] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Revised: 07/16/2014] [Accepted: 07/29/2014] [Indexed: 11/23/2022]
Abstract
We present a case of ocular toxocariasis treated successfully with oral albendazole in combination with steroids. A 26-year-old male visited the authors' clinic with the chief complaint of flying flies in his right eye. The fundus photograph showed a whitish epiretinal scar, and the fluorescein angiography revealed a hypofluorescein lesion of the scar and late leakage at the margin. An elevated retinal surface and posterior acoustic shadowing of the scar were observed in the optical coherence tomography, and Toxocara IgG was positive. The patient was diagnosed with toxocariasis, and the condition was treated with albendazole (400 mg twice a day) for a month and oral triamcinolone (16 mg for 2 weeks, once a day, and then 8 mg for 1 week, once a day) from day 13 of the albendazole treatment. The lesions decreased after the treatment. Based on this study, oral albendazole combined with steroids can be a simple and effective regimen for treating ocular toxocariasis.
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Affiliation(s)
- San Seong
- Nune Eye Hospital, Noon Building, Seoul 135-280, Korea
| | - Daruchi Moon
- Nune Eye Hospital, Noon Building, Seoul 135-280, Korea
| | - Dong Kyu Lee
- Nune Eye Hospital, Noon Building, Seoul 135-280, Korea
| | - Hyung Eun Kim
- Nune Eye Hospital, Noon Building, Seoul 135-280, Korea
| | - Hyun Sup Oh
- Nune Eye Hospital, Noon Building, Seoul 135-280, Korea
| | - Soon Hyun Kim
- Nune Eye Hospital, Noon Building, Seoul 135-280, Korea
| | - Oh Woong Kwon
- Nune Eye Hospital, Noon Building, Seoul 135-280, Korea
| | - Yong Sung You
- Nune Eye Hospital, Noon Building, Seoul 135-280, Korea
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156
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Grama DF, Lescano SZ, Pereira Mota KC, Anjos Pultz BD, Miranda JS, Silva Segundo GR, Taketomi EA, Fernandes KP, Limongi JE, de Paula FM, Chieffi PP, Cury MC. Seroprevalence of Toxocara spp. in children with atopy. Trans R Soc Trop Med Hyg 2014; 108:797-803. [DOI: 10.1093/trstmh/tru165] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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157
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Park EJ, Song JY, Choi MJ, Jeon JH, Choi JY, Yang TU, Hong KW, Noh JY, Cheong HJ, Kim WJ. Pulmonary toxocariasis mimicking invasive aspergillosis in a patient with ulcerative colitis. THE KOREAN JOURNAL OF PARASITOLOGY 2014; 52:425-8. [PMID: 25246722 PMCID: PMC4170039 DOI: 10.3347/kjp.2014.52.4.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 05/15/2014] [Accepted: 06/24/2014] [Indexed: 12/01/2022]
Abstract
A 45-year-old-male who had underlying ulcerative colitis and presented with fever and dry cough. Initially, the patient was considered to have invasive aspergillosis due to a positive galactomannan assay. He was treated with amphotericin B followed by voriconazole. Nevertheless, the patient deteriorated clinically and radiographically. The lung biopsy revealed eosinophilic pneumonia, and ELISA for Toxocara antigen was positive, leading to a diagnosis of pulmonary toxocariasis. After a 10-day treatment course with albendazole and adjunctive steroids, the patient recovered completely without any sequelae. Pulmonary toxocariasis may be considered in patients with subacute or chronic pneumonia unresponsive to antibiotic agents, particularly in cases with eosinophilia.
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Affiliation(s)
- Eun Jin Park
- Department of Internal Medicine, Korea University College of Medicine, Seoul 136-705, Korea
| | - Joon Young Song
- Department of Internal Medicine, Korea University College of Medicine, Seoul 136-705, Korea. ; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul 136-705, Korea
| | - Min Ju Choi
- Department of Internal Medicine, Korea University College of Medicine, Seoul 136-705, Korea
| | - Ji Ho Jeon
- Department of Internal Medicine, Korea University College of Medicine, Seoul 136-705, Korea
| | - Jah-Yeon Choi
- Department of Internal Medicine, Korea University College of Medicine, Seoul 136-705, Korea
| | - Tae Un Yang
- Department of Internal Medicine, Korea University College of Medicine, Seoul 136-705, Korea
| | - Kyung Wook Hong
- Department of Internal Medicine, Korea University College of Medicine, Seoul 136-705, Korea
| | - Ji Yun Noh
- Department of Internal Medicine, Korea University College of Medicine, Seoul 136-705, Korea. ; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul 136-705, Korea
| | - Hee Jin Cheong
- Department of Internal Medicine, Korea University College of Medicine, Seoul 136-705, Korea. ; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul 136-705, Korea
| | - Woo Joo Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul 136-705, Korea. ; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul 136-705, Korea
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158
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Kumar M, Sharma B, Kumar A, Lal H, Kumar V, Tripathi M. Prevalence and Haemato-Biochemical Studies of Toxocara canis Infestation in Dogs and Risk Perception of Zooneses by Dog Owners in Mathura, India. ACTA ACUST UNITED AC 2014. [DOI: 10.3923/ajava.2014.653.663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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159
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Toxocara infection in gardeners: a case control seroprevalence study. ASIAN PAC J TROP MED 2014; 7S1:S79-81. [DOI: 10.1016/s1995-7645(14)60207-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 06/13/2014] [Accepted: 06/20/2014] [Indexed: 11/23/2022] Open
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160
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Fellrath JM, Magnaval JF. Toxocariasis after slug ingestion characterized by severe neurologic, ocular, and pulmonary involvement. Open Forum Infect Dis 2014; 1:ofu063. [PMID: 25734133 PMCID: PMC4281794 DOI: 10.1093/ofid/ofu063] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 07/09/2014] [Indexed: 12/02/2022] Open
Abstract
Human toxocariasis is generally a benign, self-curing disease, and neurologic involvement is quite exceptional. In this study, we report a case of toxocariasis caused by ingestion of an unusual transport host, namely live slugs. The clinical picture comprised eosinophilic lung involvement with severe neurologic disorders in relation to vasculitis as well as retinal detachment.
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Affiliation(s)
| | - Jean-François Magnaval
- Department of Medical Parasitology , Faculty of Medicine Purpan , Toulouse , France ; CNRS UMR 5288 "Anthropobiology" , Paul-Sabatier University , Toulouse , France
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161
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Human toxocariasis: current advances in diagnostics, treatment, and interventions. Trends Parasitol 2014; 30:456-64. [PMID: 25089038 DOI: 10.1016/j.pt.2014.07.003] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 07/10/2014] [Accepted: 07/10/2014] [Indexed: 01/03/2023]
Abstract
Toxocariasis is a neglected zoonosis caused by the nematodes Toxocara canis and Toxocara cati. This disease is widespread in many countries, reaching high prevalence independently of the economic conditions. However, the true number of cases of toxocariasis is likely to be underestimated owing to the lack of adequate surveillance programs. Although some diagnostic tests are available, their sensitivity and specificity need to be improved. In addition, treatment options for toxocariasis are limited and are non-specific. Toxocariasis is listed as one of the five most important neglected diseases by the CDC. This review presents recent advances related to the control of toxocariasis, including new immunodiagnostics, therapies, and drug formulations, as well as novel interventions using DNA vaccines, immunomodulators, and probiotics.
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162
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Maraghi S, Yadyad MJ, Shamakhteh F, Latifi SM. Comparison of Toxocariasis Frequency in Hyper- eosinophilic and Non- Eosinophilic Individuals Referred to Abadan Health Centers. INTERNATIONAL JOURNAL OF ENTERIC PATHOGENS 2014. [DOI: 10.17795/ijep15908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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163
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A Comparative Seroprevalence Study of Toxocariasis in Hypereosinophilic and Apparently Healthy Individuals. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2014. [DOI: 10.5812/pedinfect.17911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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164
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Cheepsattayakorn A, Cheepsattayakorn R. Parasitic pneumonia and lung involvement. BIOMED RESEARCH INTERNATIONAL 2014; 2014:874021. [PMID: 24995332 PMCID: PMC4068046 DOI: 10.1155/2014/874021] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 05/15/2014] [Accepted: 05/20/2014] [Indexed: 11/17/2022]
Abstract
Parasitic infestations demonstrated a decline in the past decade as a result of better hygiene practices and improved socioeconomic conditions. Nevertheless, global immigration, increased numbers of the immunocompromised people, international traveling, global warming, and rapid urbanization of the cities have increased the susceptibility of the world population to parasitic diseases. A number of new human parasites, such as Plasmodium knowlesi, in addition to many potential parasites, have urged the interest of scientific community. A broad spectrum of protozoal parasites frequently affects the respiratory system, particularly the lungs. The diagnosis of parasitic diseases of airway is challenging due to their wide varieties of clinical and roentgenographic presentations. So detailed interrogations of travel history to endemic areas are critical for clinicians or pulmonologists to manage this entity. The migrating adult worms can cause mechanical airway obstruction, while the larvae can cause airway inflammation. This paper provides a comprehensive review of both protozoal and helminthic infestations that affect the airway system, particularly the lungs, including clinical and roentgenographic presentations, diagnostic tests, and therapeutic approaches.
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Affiliation(s)
- Attapon Cheepsattayakorn
- 10th Zonal Tuberculosis and Chest Disease Center, Chiang Mai, Thailand
- 10th Office of Disease Prevention and Control, Department of Disease Control, Ministry of Public Health, Chiang Mai 50100, Thailand
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165
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Archelli S, Santillan GI, Fonrouge R, Céspedes G, Burgos L, Radman N. Toxocariasis: seroprevalence in abandoned-institutionalized children and infants. Rev Argent Microbiol 2014; 46:3-6. [PMID: 24721267 DOI: 10.1016/s0325-7541(14)70040-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 01/16/2014] [Indexed: 11/17/2022] Open
Abstract
Toxocariasis is an infection that has worldwide distribution. Toxocara canis is the most relevant agent due to its frequent occurrence in humans. Soil contamination with embryonated eggs is the primary source of T. canis. This study aimed to determine the seroprevalence of toxocariasis in 10-month to 3 year-old abandoned infants, considered to be at high risk because of their orphanhood status and early age. Blood samples were collected from 120 children institutionalized in an orphanage in the city of La Plata. In this study, we observed 38.33% of seropositive cases for T. canis by ELISA and 45% by Western blot techniques; significant differences among groups A (<1 year), B (1-2 years) and C (>2 years) were also found. In research group A, children presented a seropositivity rate of 23.91%, in group B of 42.85% and in group C of 56%, which indicates an increase in frequency as age advances, probably because of greater chances of contact with infective forms of the parasite since canines and soil are frequently infected with T. canis eggs. Abandoned children come from poor households, under highly unsanitary conditions resulting from inadequate or lack of water supply and sewer networks, and frequent promiscuity with canines, which promotes the occurrence of parasitic diseases. These children are highly vulnerable due to their orphanhood status and age.
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Affiliation(s)
- Susana Archelli
- Cátedra de Parasitología Comparada, Laboratorio de Parasitosis Humanas y Zoonosis Parasitarias, Fac. Cs. Vet. UNLP, La Plata, Buenos Aires, Argentina
| | - Graciela I Santillan
- Departamento de Parasitología, INEI-ANLIS "Dr. Carlos G. Malbrán", Ciudad Autonóma de Buenos Aires, Argentina.
| | - Reinaldo Fonrouge
- Cátedra de Parasitología Comparada, Laboratorio de Parasitosis Humanas y Zoonosis Parasitarias, Fac. Cs. Vet. UNLP, La Plata, Buenos Aires, Argentina
| | - Graciela Céspedes
- Departamento de Parasitología, INEI-ANLIS "Dr. Carlos G. Malbrán", Ciudad Autonóma de Buenos Aires, Argentina
| | - Lola Burgos
- Cátedra de Parasitología Comparada, Laboratorio de Parasitosis Humanas y Zoonosis Parasitarias, Fac. Cs. Vet. UNLP, La Plata, Buenos Aires, Argentina
| | - Nilda Radman
- Cátedra de Parasitología Comparada, Laboratorio de Parasitosis Humanas y Zoonosis Parasitarias, Fac. Cs. Vet. UNLP, La Plata, Buenos Aires, Argentina
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166
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Chest CT findings of toxocariasis: Correlation with laboratory results. Clin Radiol 2014; 69:e285-90. [DOI: 10.1016/j.crad.2014.01.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 01/24/2014] [Accepted: 01/29/2014] [Indexed: 11/21/2022]
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167
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Woodhall DM, Fiore AE. Toxocariasis: A Review for Pediatricians. J Pediatric Infect Dis Soc 2014; 3:154-9. [PMID: 26625368 DOI: 10.1093/jpids/pit066] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 07/31/2013] [Indexed: 11/14/2022]
Abstract
Toxocariasis is a parasitic disease caused by roundworms of cats and dogs. The disease is endemic throughout the United States and causes significant morbidity in children, including damage to the lungs, liver, or central nervous system, especially the eyes. Two well established clinical syndromes of disease include visceral and ocular toxocariasis. Symptoms of visceral toxocariasis include abdominal pain, cough, or wheezing. Vision loss or strabismus are common symptoms of ocular toxocariasis. Serologic testing for presence of Toxocara antibody is available, although a positive test result does not necessarily correlate with active clinical infection. Albendazole or mebendazole is the recommended treatment for visceral toxocariasis. Treatment options for ocular toxocariasis include corticosteroids or ophthalmic surgery; anthelminthic medications also may be used. Risk for toxocariasis can be reduced by handwashing after soil contact, routine pets deworming, discouraging geophagia, and appropriate disposal of pet feces.
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Affiliation(s)
| | - Anthony E Fiore
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
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168
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Cassenote AJF, de Abreu Lima AR, Pinto Neto JM, Rubinsky-Elefant G. Seroprevalence and modifiable risk factors for Toxocara spp. in Brazilian schoolchildren. PLoS Negl Trop Dis 2014; 8:e2830. [PMID: 24874504 PMCID: PMC4038482 DOI: 10.1371/journal.pntd.0002830] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Accepted: 03/10/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Toxocariasis is a worldwide helminthic zoonosis caused by infection with the larvae of the ascarid worms that comprise the Toxocara spp. Children are particularly prone to infection because they are exposed to the eggs in sandboxes and playgrounds contaminated with dog and cat feces. Certain behaviors, such as a geophagy habit, poor personal hygiene, a lack of parental supervision, close contact with young dogs, and ingestion of raw meat, as well as gender, age, and socioeconomic status, affect the prevalence of the disease. However, previous studies of the risk factors for toxocariasis have generally produced inconsistent results. An epidemiological cross-sectional study was conducted to evaluate the seroprevalence of IgG anti-Toxocara spp. antibodies and associated factors in schoolchildren from a region in the southeast of Brazil. METHODOLOGY/PRINCIPAL FINDINGS A total of 252 schoolchildren aged 1 to 12 years (120 males and 132 females) were assessed. An enzyme-linked immunosorbent assay based on Toxocara canis larval excretory-secretory antigens was used to determine outcomes. A questionnaire was used to collect information on children, family, and home characteristics. Clinical and laboratory data completed the dataset investigated in this study. Seroprevalence was 15.5% (95%CI 11.5-19.8). Geophagy (aPR 2.38 [95%CI 1.36-4.18], p-value 0.029) and the habit of hand washing before meals (aPR 0.04 [95%CI 0.01-0.11], p-value ≤ 0.001) were factors associated with increased and decreased seroprevalence, respectively. The income factor and its related variables lost statistical significance after adjustment with a multiple Poisson regression model. CONCLUSIONS/SIGNIFICANCE The current study confirms that toxocariasis is a public health problem in the evaluated area; modifiable factors such as soil contact and personal hygiene appear to have a greater influence on the acquisition of infection than sociodemographic attributes, thus representing direct targets for disease prevention and control.
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Affiliation(s)
- Alex J. F. Cassenote
- Postgraduate Program in Infectious and Parasitic Diseases, Faculty of Medicine, University of São Paulo, Cerqueira César, São Paulo, Brazil
| | - Alba R. de Abreu Lima
- Faculty of Medicine of São José do Rio Preto, Department of Molecular Biology, Vila São José, São José do Rio Preto, Brazil
| | - José M. Pinto Neto
- Faculty of Health Sciences, University Camilo Castelo Branco, São Paulo, Brazil
| | - Guita Rubinsky-Elefant
- Institute of Tropical Medicine of São Paulo, University of São Paulo, Cerqueira César, São Paulo, Brazil
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169
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Kamuyu G, Bottomley C, Mageto J, Lowe B, Wilkins PP, Noh JC, Nutman TB, Ngugi AK, Odhiambo R, Wagner RG, Kakooza-Mwesige A, Owusu-Agyei S, Ae-Ngibise K, Masanja H, Osier FHA, Odermatt P, Newton CR. Exposure to multiple parasites is associated with the prevalence of active convulsive epilepsy in sub-Saharan Africa. PLoS Negl Trop Dis 2014; 8:e2908. [PMID: 24875312 PMCID: PMC4038481 DOI: 10.1371/journal.pntd.0002908] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 04/16/2014] [Indexed: 11/21/2022] Open
Abstract
Background Epilepsy is common in developing countries, and it is often associated with parasitic infections. We investigated the relationship between exposure to parasitic infections, particularly multiple infections and active convulsive epilepsy (ACE), in five sites across sub-Saharan Africa. Methods and Findings A case-control design that matched on age and location was used. Blood samples were collected from 986 prevalent cases and 1,313 age-matched community controls and tested for presence of antibodies to Onchocerca volvulus, Toxocara canis, Toxoplasma gondii, Plasmodium falciparum, Taenia solium and HIV. Exposure (seropositivity) to Onchocerca volvulus (OR = 1.98; 95%CI: 1.52–2.58, p<0.001), Toxocara canis (OR = 1.52; 95%CI: 1.23–1.87, p<0.001), Toxoplasma gondii (OR = 1.28; 95%CI: 1.04–1.56, p = 0.018) and higher antibody levels (top tertile) to Toxocara canis (OR = 1.70; 95%CI: 1.30–2.24, p<0.001) were associated with an increased prevalence of ACE. Exposure to multiple infections was common (73.8% of cases and 65.5% of controls had been exposed to two or more infections), and for T. gondii and O. volvulus co-infection, their combined effect on the prevalence of ACE, as determined by the relative excess risk due to interaction (RERI), was more than additive (T. gondii and O. volvulus, RERI = 1.19). The prevalence of T. solium antibodies was low (2.8% of cases and 2.2% of controls) and was not associated with ACE in the study areas. Conclusion This study investigates how the degree of exposure to parasites and multiple parasitic infections are associated with ACE and may explain conflicting results obtained when only seropositivity is considered. The findings from this study should be further validated. The prevalence of epilepsy is greater in developing countries compared to developed countries, and parasitic infestations are thought to contribute to this increased burden. We conducted a case-control study across five sites in sub-Saharan Africa to investigate the relationship between epilepsy and exposure to parasitic infections, and the association between epilepsy and multiple co-incidental infections. Exposure to Onchocerca volvulus, Toxocara canis and Toxoplasma gondii as well as high antibody levels (top tertile) to Toxocara canis was positively associated with the prevalence of active convulsive epilepsy (ACE). Multiple co-incidental parasitic infections were common, and the combined effect of T. gondii and O. volvulus co-infection on ACE was greater than the sum of the individual effects. The contribution of each of these parasitic infections on the burden of epilepsy in sub-Saharan Africa should be explored.
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Affiliation(s)
- Gathoni Kamuyu
- KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research – Coast, Kilifi, Kenya
- Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network, Accra, Ghana
- * E-mail:
| | - Christian Bottomley
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- MRC Tropical Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - James Mageto
- KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research – Coast, Kilifi, Kenya
- Egerton University, Nakuru, Kenya
| | - Brett Lowe
- KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research – Coast, Kilifi, Kenya
- Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network, Accra, Ghana
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Patricia P. Wilkins
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - John C. Noh
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Thomas B. Nutman
- Laboratory of Parasitic Diseases. National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - Anthony K. Ngugi
- KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research – Coast, Kilifi, Kenya
- Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network, Accra, Ghana
- Research Support Unit, Faculty of Health Sciences, Aga Khan University (East Africa), Nairobi, Kenya
| | - Rachael Odhiambo
- KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research – Coast, Kilifi, Kenya
| | - Ryan G. Wagner
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Epidemiology and Public Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Angelina Kakooza-Mwesige
- Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network, Accra, Ghana
- Iganga-Mayuge Health and Demographic Surveillance System, Iganga, Uganda
- Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | | | | | | | - Faith H. A. Osier
- KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research – Coast, Kilifi, Kenya
| | - Peter Odermatt
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- Unversity of Basel, Basel, Switzerland
| | - Charles R. Newton
- KEMRI/Wellcome Trust Research Programme, The Centre of Geographical Medicine Research – Coast, Kilifi, Kenya
- Studies of the Epidemiology of Epilepsy in Demographic Surveillance Systems (SEEDS)-INDEPTH Network, Accra, Ghana
- Neurosciences Unit, UCL Institute of Child Health, London, United Kingdom
- Clinical Research Unit, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Woodhall DM, Eberhard ML, Parise ME. Neglected parasitic infections in the United States: toxocariasis. Am J Trop Med Hyg 2014; 90:810-813. [PMID: 24808249 PMCID: PMC4015569 DOI: 10.4269/ajtmh.13-0725] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 01/09/2014] [Indexed: 11/30/2022] Open
Abstract
Toxocariasis is a preventable parasitic disease that is caused by the dog and cat roundworms Toxocara cani and T. cati, respectively. Humans become infected when they accidently ingest infectious Toxocara eggs commonly found in contaminated soil; children are most often affected. Clinical manifestations of Toxocara infection in humans include ocular toxocariasis and visceral toxocariasis. Although infection with Toxocara can cause devastating disease, the burden of toxocariasis in the United States population remains unknown. In addition, risk factors for acquiring infection need to be better defined, and research needs to be conducted to better understand the pathophysiology and clinical course of toxocariasis. Development of diagnostic tests would enable clinicians to detect active infection, and determination of optimal drug regiments would ensure patients were appropriately treated. Addressing these public health gaps is necessary to understand and address the impact of toxocariasis in the United States.
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Affiliation(s)
- Dana M. Woodhall
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
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171
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Avila LFDCD, Telmo PDL, Martins LHR, Glaeser TA, Conceição FR, Leite FPL, Scaini CJ. Protective effect of the probiotic Saccharomyces boulardii in Toxocara canis infection is not due to direct action on the larvae. Rev Inst Med Trop Sao Paulo 2014; 55:363-5. [PMID: 24037293 PMCID: PMC4105076 DOI: 10.1590/s0036-46652013000500012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 03/22/2013] [Indexed: 11/25/2022] Open
Abstract
In a previous study our group found that the probiotic
Saccharomyces boulardii was capable of reducing the
intensity of infection in mice with toxocariasis. In order to assess whether the
mechanism involved would be a direct action of the probiotic on Toxocara
canis larvae, this study was designed. Both probiotics were singly
cultivated in plates containing RPMI 1640 medium and T. canis
larvae. S. boulardii and B. cereus var. toyoi
cultures presented 97.6% and 95.7% of larvae with positive motility,
respectively, and absence of color by the dye trypan blue, not representing
significant difference to the control group (p > 0.05). We
conclude that none of the probiotics showed in vitro effects on
T. canis larvae and that the interaction with the
intestinal mucosa is necessary for the development of the protective effect of
S. boulardii.
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Affiliation(s)
- Luciana Farias da Costa de Avila
- Universidade Federal de Pelotas, 96010-900PelotasRSBrazilPost-Graduate Program in Parasitology, Universidade Federal de Pelotas (UFPEL); Campus Universitário, Caixa Postal 354, 96010-900 Pelotas, RS, Brazil. Tel.: 55.53.3275-7350, Fax: 55.53.3275-7350
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172
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McGuinness SL, Leder K. Global Burden of Toxocariasis: A Common Neglected Infection of Poverty. CURRENT TROPICAL MEDICINE REPORTS 2014. [DOI: 10.1007/s40475-013-0012-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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173
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Abstract
A healthy 46-year-old man presented with decreased vision in the right eye after ingestion of raw meat. On funduscopic examination, a cystic lesion was found on an edematous right optic disc with adjacent serous retinal detachment. Optical coherence tomography confirmed a peripapillary serous retinal detachment and a well-demarcated cystic lesion (200 × 200 × 500 μm) in the right eye. The patient had moderate eosinophilia and was seropositive for anti-Toxocara IgG antibody. Diagnosed with ocular toxocariasis, he was treated with systemic corticosteroids and albendazole with improvement in vision and fundus appearance.
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175
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Bellanger AP, Runge M, Wendling D, Humbert P. Lumbar myositis associated with Toxocara spp. infection. ACTA ACUST UNITED AC 2013; 10:54-5. [PMID: 24239450 DOI: 10.1016/j.reuma.2013.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 04/17/2013] [Accepted: 04/19/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Anne-Pauline Bellanger
- Department of Parasitology-Mycology, University Hospital, Besançon, France; CNRS-University of Franche-Comte/UMR 6249 Chrono-environnement, Besançon, France.
| | - Michel Runge
- Department of Radiology, University Hospital, Besançon, France
| | - Daniel Wendling
- Department of Rheumatology, University Hospital, Besançon, France
| | - Philippe Humbert
- Department of Dermatology, University Hospital, Besançon, France; SFR FED 4234 IBCT Cell and Tissue Engineering and Biology, INSERM U 1098_University of Franche-Comte, Besançon, France
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176
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Abstract
Many hundreds of millions of people throughout the world are infected by nematodes found in the intestine or tissues with a high prevalence in developing countries. Despite their frequency and morbidity, these infections, which may affect migrants and travelers, remain difficult to diagnosis even in developed countries. This is primarily due to the variety of clinical signs often associated with a lack of highly sensitive and specific diagnostic tools. Parasitological diagnosis is often difficult to achieve and can neither be applied during the pre-patent period nor for parasitic impasses. Serological diagnosis is frequently hampered by a lack of specificity due to cross-reaction with others helminthes. Molecular biology methods still require optimization. The diagnostic approach applied by a clinician of a suspected nematode infection is based on a vast set of data including patient history and way of life, clinical examination, non-specific biological tests and, when available, specific diagnostic tests.
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Affiliation(s)
- Coralie L'Ollivier
- Parasitology & Mycology, CHU Timone-Adultes, Aix Marseille Université, Assistance Publique-Hôpitaux de Marseille, 13005 Marseille, France
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MIKAEILI F, MIRHENDI H, HOSSEINI M, ASGARI Q, KIA EB. Toxocara nematodes in stray cats from shiraz, southern iran: intensity of infection and molecular identification of the isolates. IRANIAN JOURNAL OF PARASITOLOGY 2013; 8:593-600. [PMID: 25516741 PMCID: PMC4266124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 10/08/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND Toxocara is a common nematode of cats in different parts of Iran. Despite the close association of cats with human, no attempt has been done so far for molecular identification of this nematode in the country. Therefore, current study was performed on identification of some isolates of Toxocara from stray cats in Shiraz, Fars Province, Southern Iran, based on morphological and molecular approaches, and also determination of intensity of infection. METHODS This cross-sectional study was carried out on 30 stray cats trapped from different geographical areas of Shiraz in 2011. Adult male and female worms were recovered from digestive tract after dissection of cats. Morphological features using existing keys and PCR-sequencing of ITS-rDNA region and pcox1 mitochondrial l gene were applied for the delineating the species of the parasites. RESULTS Eight out of 30 cats (26.7%) were found infected with Toxocara nematodes. All the isolates were confirmed as Toxocara cati based on morphological features and the sequence of ribosomal and mitochondrial targets. Intensity of infection ranged from one to a maximum of 39 worms per cat, with a mean of 10.25±12.36, and higher abundance of female nematodes. CONCLUSION The most prevalent ascaridoid nematode of stray cats in the study area was T. cati and female nematodes were more abundant than that of males. This issue has important role in spreading of eggs in the environment and impact on human toxocariasis.
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Affiliation(s)
- Fattaneh MIKAEILI
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein MIRHENDI
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa HOSSEINI
- Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Qasem ASGARI
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Eshrat Beigom KIA
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran,Correspondence
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Norhaida A, Suharni M, Liza Sharmini AT, Tuda J, Rahmah N. rTES-30USM: cloning via assembly PCR, expression, and evaluation of usefulness in the detection of toxocariasis. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2013; 102:151-60. [DOI: 10.1179/136485908x252250] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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179
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Toxocara spp. seroprevalence in sheep from southern Brazil. Parasitol Res 2013; 112:3181-6. [DOI: 10.1007/s00436-013-3499-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 06/03/2013] [Indexed: 10/26/2022]
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180
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Prevalence and risk factors associated with Toxocara canis infection in children. ScientificWorldJournal 2013; 2013:572089. [PMID: 23844404 PMCID: PMC3690266 DOI: 10.1155/2013/572089] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 05/15/2013] [Indexed: 11/17/2022] Open
Abstract
The objective of this study was to determine seroprevalence and identify risk factors associated with Toxocara canis infection. A clinical and epidemiological questionnaire and body mass index were used to assess the risk factors associated with human toxocariasis in 108 children with an age range of 2-16 years. Antibodies against Toxocara canis were detected using an ELISA test kit. Chi-square analysis and odds ratio (OR) were used to identify risk factors associated with Toxocara canis seropositivity. The prevalence of antibodies against Toxocara canis was greater (P = 0.02) in males than females (28.84% and 16.07%, resp.). Chi-square analysis and odds ratio revealed just one variable with P < 0.05, and OR > 1.0 was associated with seropositivity: the possession of dogs under one year old (OR = 1.78). Although not significant, the OR values suggest that other factors may be epidemiologically important for Toxocara presence such as not washing hands before meals, malnutrition, obesity, and use of public parks. Children in the age group >12 and <16 years old had higher seroprevalence to Toxocara canis (17.59%) than the >2 and <11 years old age group (4.62%). Toxocariosis infection needs to be prevented by pet deworming and hygienic measures after contact with dogs.
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Khademvatan S, Rahim F, Tavalla M, Abdizadeh R, Hashemitabar M. PCR-based molecular characterization of Toxocara spp. using feces of stray cats: a study from Southwest Iran. PLoS One 2013; 8:e65293. [PMID: 23755213 PMCID: PMC3670902 DOI: 10.1371/journal.pone.0065293] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Accepted: 04/22/2013] [Indexed: 11/18/2022] Open
Abstract
Feces of stray cat are potential sources of gastrointestinal parasites and play a crucial role in spreading and transmitting parasite eggs, larvae, and oocysts through contamination of soil, food, or water. In this study, we investigated the prevalence of Toxocara spp. infection in stray cats in Ahvaz city, southwest Iran. Eggs of Toxocara spp. in feces of stray cats were detected by the sucrose flotation method, and identification was conducted by polymerase chain reaction (PCR) and DNA sequencing. Of the 140 fecal samples that were randomly collected from public environments during the months of January to May 2012, 45% were found to harbour Toxocara spp. eggs. The highest prevalence of Toxocara spp. eggs was found in the central area of Ahvaz city (28.6%). T. canis eggs were found in 4 (6.34%) of the 63 positive samples. Stray cats are found in parks, playgrounds, and other public places and may be a potential contamination risk. Identification of Toxocara spp. using molecular methods is sufficiently sensitive to detect low levels of parasites and identify the different Toxocara spp. in feces. The relatively high prevalence of Toxocara spp. infection may continue to increase due to lack of effective environmental hygiene control in Iran. Consequently, there is a need to plan adequate programs to detect, identify, and control this infection as well as stray cats in the region.
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Affiliation(s)
- Shahram Khademvatan
- Cellular and Molecular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Medical Parasitology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- * E-mail: (SK); (FR)
| | - Fakher Rahim
- Toxicology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- * E-mail: (SK); (FR)
| | - Mahdi Tavalla
- Department of Medical Parasitology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Rahman Abdizadeh
- Department of Medical Parasitology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahmoud Hashemitabar
- Cellular and Molecular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Othman AA, Ashour DS, Mohamed DA. Toxocara-induced hepatic inflammation: Immunohistochemical characterization of lymphocyte subpopulations and Bcl-2 expression. Exp Parasitol 2013; 134:76-81. [DOI: 10.1016/j.exppara.2013.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 01/30/2013] [Accepted: 02/04/2013] [Indexed: 11/25/2022]
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183
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Alvarado-Esquivel C. Toxocara infection in psychiatric inpatients: a case control seroprevalence study. PLoS One 2013; 8:e62606. [PMID: 23626838 PMCID: PMC3633879 DOI: 10.1371/journal.pone.0062606] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 03/21/2013] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND There is poor knowledge about the epidemiology of toxocariasis in psychiatric patients. AIMS Determine the seroepidemiology of Toxocara infection in psychiatric patients. METHODS Through a case-control seroprevalence study, 128 psychiatric inpatients and 276 control subjects were compared for the presence of anti-Toxocara IgG antibodies in Durango, Mexico. Socio-demographic, clinical, and behavioral characteristics of inpatients associated with toxocariasis were also investigated. RESULTS Six of the 128 (4.7%) psychiatric inpatients, and 3 (1.1%) of the 276 controls were positive for anti-Toxocara IgG antibodies (P = 0.03). Stratification by age showed that Toxocara seroprevalence was significantly (P = 0.02) higher in patients aged ≤50 years old (6/90∶6.7%) than controls of the same age (2/163∶1.2%). While Toxocara seroprevalence was similar in patients and controls aged >50 years old. Stratification by gender showed that Toxocara seroprevalence was significantly (P = 0.03) higher in female patients (2/37∶5.4%) than in female controls (0/166∶0%). No statistically significant associations between Toxocara seropositivity and clinical characteristics were found. In contrast, Toxocara seropositivity was associated with consumption of goat meat and raw sea snail. CONCLUSIONS This is the first report of toxocariasis in psychiatric inpatients in Mexico. Further studies with larger sample sizes are needed to elucidate the association of toxocariasis with psychiatric diseases. The role of the consumption of goat meat and raw sea snail in the transmission of Toxocara deserve further investigation.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Department of Infectology, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango, Mexico.
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184
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Abstract
SUMMARYSeroprevalence data illustrate that human exposure to Toxocara is frequent. Environmental contamination with Toxocara spp. eggs is assumed to be the best indicator of human exposure, but increased risk of exposure has also been associated with many other factors. Reported associations are inconsistent, however, and there is still ambiguity regarding the factors driving the onset of Toxocara antibody positivity. The objective of this work was to assess the validity of our current conceptual understanding of the key processes driving human exposure to Toxocara. We constructed an agent-based model predicting Toxocara antibody positivity (as a measure of exposure) in children. Exposure was assumed to depend on the joint probability of 3 parameters: (1) environmental contamination with Toxocara spp. eggs, (2) larvation of these eggs and (3) the age-related contact with these eggs. This joint probability was linked to processes of acquired humoral immunity, influencing the rate of antibody seroreversion. The results of the simulation were validated against published data from 5 different geographical settings. Using simple rules and a stochastic approach with parameter estimates derived from the respective contexts, plausible serological patterns emerged from the model in nearly all settings. Our approach leads to novel insights in the transmission dynamics of Toxocara.
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185
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Bojanich MV, Marino GL, López MÁ, Alonso JM. An evaluation of the dot-ELISA procedure as a diagnostic test in an area with a high prevalence of human Toxocara canis infection. Mem Inst Oswaldo Cruz 2013; 107:194-7. [PMID: 22415257 DOI: 10.1590/s0074-02762012000200007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 12/14/2011] [Indexed: 11/22/2022] Open
Abstract
The aim of this work was to evaluate a dot-enzyme-linked immunosorbent assay (dot-ELISA) using excretory-secretory antigens from the larval stages of Toxocara canis for the diagnosis of toxocariasis. A secondary aim was to establish the optimal conditions for its use in an area with a high prevalence of human T. canis infection. The dot-ELISA test was standardised using different concentrations of the antigen fixed on nitrocellulose paper strips and increasing dilutions of the serum and conjugate. Both the dot-ELISA and standard ELISA methods were tested in parallel with the same batch of sera from controls and from individuals living in the problem area. The best results were obtained with 1.33 µg/mL of antigen, dilutions of 1/80 for the samples and controls and a dilution of 1/5,000 for the anti-human IgG-peroxidase conjugate. All steps of the procedure were performed at room temperature. The coincidence between ELISA and dot-ELISA was 85% and the kappa index was 0.72. The dot-ELISA test described here is rapid, easy to perform and does not require expensive equipment. Thus, this test is suitable for the serological diagnosis of human T. canis infection in field surveys and in the primary health care centres of endemic regions.
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Affiliation(s)
- María V Bojanich
- Área de Microbiología, Facultad de Ciencias Exactas y Naturales y Agrimensura, Corrientes, Argentina.
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186
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A perfect time to harness advanced molecular technologies to explore the fundamental biology of Toxocara species. Vet Parasitol 2013; 193:353-64. [DOI: 10.1016/j.vetpar.2012.12.031] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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187
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Fan CK, Liao CW, Cheng YC. Factors affecting disease manifestation of toxocarosis in humans: Genetics and environment. Vet Parasitol 2013; 193:342-52. [DOI: 10.1016/j.vetpar.2012.12.030] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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188
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189
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Arevalo JF, Espinoza JV, Arevalo FA. Ocular toxocariasis. J Pediatr Ophthalmol Strabismus 2013; 50:76-86. [PMID: 22938514 DOI: 10.3928/01913913-20120821-01] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Accepted: 07/26/2012] [Indexed: 11/20/2022]
Abstract
Ocular toxocariasis is an uncommon worldwide parasitic infection that affects mostly children and is found in both rural and metropolitan areas. In many parts of the world, parasitic infections of the eye are a major cause of blindness. The diagnosis of toxocariasis is essentially clinical, based on the lesion morphology and supportive laboratory data such as serum enzyme-linked immunosorbent assay (ELISA) titers and ELISA Toxocara titers on aqueous humor; other diagnostic methods are imaging studies including optical coherence tomography, fluorescein angiography, computed tomography, and ocular ultrasound. Treatment is directed at complications arising from intraocular inflammation and vitreous membrane traction. Early vitrectomy may be of value both diagnostically and therapeutically.
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Affiliation(s)
- J Fernando Arevalo
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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190
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Hassan HA, Majid RA, Rashid NG, Nuradeen BE, Abdulkarim QH, Hawramy TA, Rashid RM, Farris AB, Guarner J, Hughson MD. Eosinophilic granulomatous gastrointestinal and hepatic abscesses attributable to basidiobolomycosis and fasciolias: a simultaneous emergence in Iraqi Kurdistan. BMC Infect Dis 2013; 13:91. [PMID: 23421741 PMCID: PMC3583806 DOI: 10.1186/1471-2334-13-91] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 02/01/2013] [Indexed: 11/10/2022] Open
Abstract
Background Deep eosinophilic granulomatous abscesses, as distinguished from eosinophilic subcutaneous abscesses, are rare. Most reports are from the Far-East and India where the most commonly attributed cause is Toxocara. Sulaimaniyah in Northeastern Iraq has experienced an outbreak of eosinophilic granulomatous liver and gastrointestinal (GI) abscesses beginning in 2009. The purpose of this study was to determine the etiology and guide treatment. Methods The study was an ongoing investigation of patients having a histopathologic diagnosis of eosinophilic granulomatous abdominal abscesses in Sulaimaniyah hospitals from May 2009 to August 2012. Tissues were examined for organisms, and Enzyme Linked Immunoabsorbent Assays (ELISA) were performed for serum antibodies to Fasciola hepatica, Toxocara, and Echinococcus granulosus. Results Fourteen patients had granulomatous inflammation surrounding a central necrotizing eosinophilic exudate identified in surgical pathology specimens from abdominal surgeries. Two children and four adults had abscesses that formed GI masses. These patients included a 39 year old male with oropharyngeal and transverse colon disease, and a 48 year old male with liver and GI abscesses. All sites demonstrated a Zygomycete fungus surrounded by eosinophilic Splendori-Hoeppli material consistent with basidiobolomycosis. Five of the six patients with fungal disease were treated by surgery and 4 to 7 months of itraconozol. One child died of intestinal perforation while receiving IV amphotericin B; two adults required additional surgery for recurrent GI obstruction. Eight patients had isolated liver abscesses with no organisms identified by histopathology: ELISA results for F. hepatica were positive for five, borderline for one, and negative for two patients. These eight patients were treated for fascioliasis by surgical resection of localized abscesses and albendazol. One patient serologically positive for F. Hepatica was found to have a common duct fluke two years after initial diagnosis. Serological testing for Toxocara and Echinococcus granulosus was negative in all 14 patients. Conclusions Basidiobolomycosis and F. hepatica are implicated as the cause of abdominal eosinophilic granulomatous abscesses in 12 of 14 patients identified over a period of 40 months in northern Iraq. Treatment was complicated by chronic biliary tract disease in fascioliasis and perforation and recurrent intestinal obstruction with basidiobolomycosis.
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Affiliation(s)
- Hemmin A Hassan
- Department of Pathology, Shorsh General Hospital, and Department of Microbiology, Sulaimaniyah University College of Medicine, Sulaimaniyah, Iraq
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191
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Alvarado-Esquivel C. Toxocariasis in waste pickers: a case control seroprevalence study. PLoS One 2013; 8:e54897. [PMID: 23349987 PMCID: PMC3551773 DOI: 10.1371/journal.pone.0054897] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Accepted: 12/17/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The epidemiology of Toxocara infection in humans in Mexico has been poorly explored. There is a lack of information about Toxocara infection in waste pickers. AIMS Determine the seroepidemiology of Toxocara infection in waste pickers. METHODS Through a case control study design, the presence of anti-Toxocara IgG antibodies was determined in 90 waste pickers and 90 age- and gender-matched controls using an enzyme-linked immunoassay. Associations of Toxocara exposure with socio-demographic, work, clinical, and behavioral data of the waste pickers were also evaluated. RESULTS The seroprevalence of anti-Toxocara IgG antibodies was significantly higher in waste pickers (12/90: 13%) than in control subjects (1/90: 1%) (OR = 14; 95% CI: 2-288). The seroprevalence was not influenced by socio-demographic or work characteristics. In contrast, increased seroprevalence was found in waste pickers suffering from gastritis, and reflex and visual impairments. Multivariate analysis showed that Toxocara exposure was associated with a low frequency of eating out of home (OR = 26; 95% CI: 2-363) and negatively associated with consumption of chicken meat (OR = 0.03; 95% CI: 0.003-0.59). Other behavioral characteristics such as animal contacts or exposure to soil were not associated with Toxocara seropositivity. CONCLUSIONS 1) Waste pickers are a risk group for Toxocara infection. 2) Toxocara is impacting the health of waste pickers. This is the first report of Toxocara exposure in waste pickers and of associations of gastritis and reflex impairment with Toxocara seropositivity. Results warrant for further research.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Department of Infectology, Faculty of Medicine and Nutrition, Juárez University of Durango State, Durango, Mexico.
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Abstract
Toxocariasis is a helminth zoonosis caused by infection with the larvae of Toxocara spp. ascarid worms. Only two species, Toxocara canis and Toxocara cati, are recognised as causative agents of human disease. The best choice for serodiagnosis of the generalised forms of toxocariasis, visceral larva migrans (VLM) or covert toxocariasis, relies upon the initial use of TES-ELISA, after which any positive result should subsequently be tested by Western blotting (WB). Covert toxocariasis is mostly a benign infection, so a large majority of infected subjects are asymptomatic or have very few symptoms and therefore go undiagnosed. In this form, this helminthosis is often self-limiting, leaving residual specific antibodies. A positive serodiagnosis caused by residual antibodies that do not have any diagnostic significance can be associated with any infectious or non-infectious disease. If separated from the ongoing clinical and laboratory context, such a positive result has no diagnostic value and should be only taken into account after the possible etiologies of any observed syndromes have been ruled out. Unlike the methods used for the immunodiagnosis of bacterial, viral or protozoal (toxoplasmosis) infections, it is not possible with toxocariasis to assess the age of the presence of specific IgG using the levels of specific IgM because IgM antibodies can be found throughout the course of helminthiasis. The detection of other classes of immunoglobulins, namely IgE and IgA, the subclasses, namely IgG4 or circulating Ag was proven to be unable to discriminate between active and self-cured generalised toxocaral infections. Currently, the diagnosis of an active covert toxocariasis relies upon indirect arguments, e.g., the presence of otherwise unexplained symptoms along with blood eosinophilia and/or elevated levels of eosinophil cationic protein (ECP). This situation is far from ideal and more research should be carried out to solve this difficult problem.
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194
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Othman AA. Therapeutic battle against larval toxocariasis: are we still far behind? Acta Trop 2012; 124:171-8. [PMID: 22921951 DOI: 10.1016/j.actatropica.2012.08.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Revised: 07/29/2012] [Accepted: 08/07/2012] [Indexed: 11/27/2022]
Abstract
Toxocariasis is a widespread zoonotic helminthic disease. Human infection is acquired by ingestion of embryonated eggs of Toxocara which reach the environment via stools of dogs and cats. In paratenic hosts, such as humans and mice, the hatched larvae migrate systematically in the body and could reach critical sites such as the eye and the central nervous system. The clinical expression of toxocariasis includes two main forms of varying intensity: visceral and ocular, as well as several organ-specific clinical manifestations. The issue of treatment is a matter of great controversy not only because of limited efficacy of anthelmintic drugs in terms of parasite eradication, but also because of doubts about the benefits of therapy as most Toxocara infections are self-limiting. Many animal studies were conducted employing different drugs and regimens, yet the results were variable and inconsistent. On the other hand, experience in human therapy is unfortunately limited due to paucity of clinical trials. Herein, the problems and pitfalls of treatment of toxocariasis are addressed, and new trends in therapy are discussed.
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Affiliation(s)
- Ahmad A Othman
- Department of Medical Parasitology, Faculty of Medicine, Tanta University, Egypt.
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Nagy D, Bede O, Danka J, SzÉnási Z, Sipka S. Analysis of serum cytokine levels in children with chronic cough associated withToxocara canisinfection. Parasite Immunol 2012; 34:581-8. [DOI: 10.1111/pim.12010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 08/06/2012] [Indexed: 02/02/2023]
Affiliation(s)
- D. Nagy
- Department of Paediatric; Faculty of Medicine; University of Szeged; Albert Szent-Györgyi Medical and Pharmaceutical Centre; Szeged; Hungary
| | - O. Bede
- Department of Paediatric; Faculty of Medicine; University of Szeged; Albert Szent-Györgyi Medical and Pharmaceutical Centre; Szeged; Hungary
| | - J. Danka
- National Centre for Epidemiology; Budapest; Hungary
| | - Z. SzÉnási
- National Centre for Epidemiology; Budapest; Hungary
| | - S. Sipka
- Department of Internal Medicine; University Medical School of Debrecen; Debrecen; Hungary
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Chen J, Zhou DH, Nisbet AJ, Xu MJ, Huang SY, Li MW, Wang CR, Zhu XQ. Advances in molecular identification, taxonomy, genetic variation and diagnosis of Toxocara spp. INFECTION GENETICS AND EVOLUTION 2012; 12:1344-8. [DOI: 10.1016/j.meegid.2012.04.019] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Revised: 04/20/2012] [Accepted: 04/21/2012] [Indexed: 12/28/2022]
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Kim JH, Chung WB, Chang KY, Ko SY, Park MH, Sa YK, Choi YS, Park CS, Lee MY. Eosinophilic myocarditis associated with visceral larva migrans caused by Toxocara canis infection. J Cardiovasc Ultrasound 2012. [PMID: 23185659 PMCID: PMC3498313 DOI: 10.4250/jcu.2012.20.3.150] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 41-year-old woman who was diagnosed with myocarditis presented eosinophilia. Since the antibody against Toxocara canis (T. canis) was positive, we diagnosed that she had visceral larva migrans due to T. canis associated with myocarditis. She was treated with oral albendazole and prednisolone for two weeks, eosinophil count and hepatic enzymes were normalized after completion of treatment. This is the first report of myocarditis caused by T. canis infection in Korea.
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Affiliation(s)
- Ji Hee Kim
- Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Abstract
Liver disease is an important source of morbidity among ill returning travelers. Jaundice is one of the most common and obvious symptoms of liver disease, the differential diagnosis of which is extensive, especially in travelers. Jaundice in travelers can arise from both infectious and noninfectious causes. We herein summarize the most common parasitic etiologies that may lead to jaundice in the returned traveler, visitors of friends and relatives, or new immigrants, and describe the etiology, epidemiology, and pathogenesis of clinical features of each.
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Affiliation(s)
- Wilson W Chan
- Calgary Laboratory Services, Calgary, Alberta, Canada
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Noh Y, Hong ST, Yun JY, Park HK, Oh JH, Kim YE, Jeon BS. Meningitis by Toxocara canis after ingestion of raw ostrich liver. J Korean Med Sci 2012; 27:1105-8. [PMID: 22969260 PMCID: PMC3429831 DOI: 10.3346/jkms.2012.27.9.1105] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 05/25/2012] [Indexed: 01/22/2023] Open
Abstract
Recently reports on toxocariasis are increasing by serodiagnosis in Korea. A previously healthy 17-yr-old boy complained of headache, fever, dyspnea, and anorexia. He showed symptoms and signs of eosinophilic meningitis with involvement of the lungs and liver. Specific IgG antibody to Toxocara canis larval antigen was positive in serum and cerebrospinal fluid by ELISA. He took raw ostrich liver with his parents 4 weeks before the symptom onset. His parents were seropositive for T. canis antigen but had no symptoms or signs suggesting toxocariasis. This is the first report of toxocariasis in a family due to ingestion of raw ostrich liver in Korea.
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Affiliation(s)
- Young Noh
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Sung-Tae Hong
- Department of Parasitology and Tropical Medicine, Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Young Yun
- Department of Neurology, Ewha Womans University Medical Center, Seoul, Korea
| | - Hong-Kyun Park
- Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Hwan Oh
- Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young Eun Kim
- Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Beom S. Jeon
- Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Quattrocchi G, Nicoletti A, Marin B, Bruno E, Druet-Cabanac M, Preux PM. Toxocariasis and epilepsy: systematic review and meta-analysis. PLoS Negl Trop Dis 2012; 6:e1775. [PMID: 22905274 PMCID: PMC3419195 DOI: 10.1371/journal.pntd.0001775] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 06/29/2012] [Indexed: 11/18/2022] Open
Abstract
Objective Human toxocariasis is a zoonotic infection caused by the larval stages of Toxocara canis (T. canis) and less frequently Toxocara cati (T. cati). A relationship between toxocariasis and epilepsy has been hypothesized. We conducted a systematic review and a meta-analysis of available data to evaluate the strength of association between epilepsy and Toxocara spp. seropositivity and to propose some guidelines for future surveys. Data Sources Electronic databases, the database from the Institute of Neuroepidemiology and Tropical Neurology of the University of Limoges (http://www-ient.unilim.fr/) and the reference lists of all relevant papers and books were screened up to October 2011. Methods We performed a systematic review of literature on toxocariasis (the exposure) and epilepsy (the outcome). Two authors independently assessed eligibility and study quality and extracted data. A common odds ratio (OR) was estimated using a random-effects meta-analysis model of aggregated published data. Results Seven case-control studies met the inclusion criteria, for a total of 1867 participants (850 cases and 1017 controls). The percentage of seropositivity (presence of anti-Toxocara spp. antibodies) was higher among people with epilepsy (PWE) in all the included studies even if the association between epilepsy and Toxocara spp. seropositivity was statistically significant in only 4 studies, with crude ORs ranging 2.04–2.85. Another study bordered statistical significance, while in 2 of the included studies no significant association was found. A significant (p<0.001) common OR of 1.92 [95% confidence interval (CI) 1.50–2.44] was estimated. Similar results were found when meta-analysis was restricted to the studies considering an exclusively juvenile population and to surveys using Western Blot as confirmatory or diagnostic serological assay. Conclusion Our results support the existence of a positive association between Toxocara spp. seropositivity and epilepsy. Further studies, possibly including incident cases, should be performed to better investigate the relationship between toxocariasis and epilepsy. Human toxocariasis is an infection caused by the larval stage of the worms Toxocara canis and less frequently Toxocara cati, common parasites of domestic and peridomestic dogs and cats. It is a cosmopolitan infection, occurring whenever the man-soil-dog relationship is particularly close, especially in tropical countries, where the humid climate favours the survival of parasite eggs in the soil, and in rural settings, where the poor hygiene increases the probability of human infection. Epilepsy affects nowadays at least 65 million of people worldwide and is particularly common in tropical areas, probably because of the presence of cases caused by infectious diseases largely absent in industrialized countries. For several decades, researchers have investigated the possible association between toxocariasis and epilepsy. In this study we conducted a statistical analysis of all the data available on the relationship between these two conditions. The combined results of the 7 studies included indicate an association between the two diseases. Further studies are necessary to demonstrate a causal relationship (i.e. toxocariasis causes epilepsy). Considering that toxocariasis is a preventable and common disease, a better understanding of the relationship between toxocariasis and epilepsy may contribute to improving prevention of epilepsy worldwide.
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Affiliation(s)
- Graziella Quattrocchi
- Department GF Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Department GF Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Benoit Marin
- INSERM U1094, Tropical Neuroepidemiology, Limoges, France
- University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, Limoges, France
- CNRS FR 3503 GEIST, Limoges, France
- CHU Limoges, France
| | - Elisa Bruno
- Department GF Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Michel Druet-Cabanac
- INSERM U1094, Tropical Neuroepidemiology, Limoges, France
- University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, Limoges, France
- CNRS FR 3503 GEIST, Limoges, France
- CHU Limoges, France
| | - Pierre-Marie Preux
- INSERM U1094, Tropical Neuroepidemiology, Limoges, France
- University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, Limoges, France
- CNRS FR 3503 GEIST, Limoges, France
- CHU Limoges, France
- * E-mail:
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