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Shayanfar S, Bahadory S, Taghipour A, Foroutan M, Abdoli A. Seroprevalence of Toxocara spp. in Pregnant Women: A Systematic Review and Meta-Analysis. Infect Dis Obstet Gynecol 2024; 2024:1943353. [PMID: 38682081 PMCID: PMC11055642 DOI: 10.1155/2024/1943353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/01/2024] [Accepted: 04/08/2024] [Indexed: 05/01/2024] Open
Abstract
Background Toxocariasis is an important health problem caused by the parasitic species Toxocara canis (T. canis) and Toxocara cati (T. cati). Prevalence of toxocariasis in pregnant women as a vulnerable population is doubly important, and the aim of this study is to estimate the overall prevalence of toxocariasis infection in pregnant women according to the available reports. Methods The present study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklists. A systematic search was carried out in international scientific databases (Google Scholar, Web of Science, ScienceDirect, Scopus, and PubMed) between 1990 and 2023. The overall prevalence of parasitic infection was estimated with a random-effects model. All analyses (overall prevalence, heterogeneity, publication bias, and sensitivity analysis) were performed with comprehensive meta-analysis (V2.2, Bio stat) software. Results Amid the final eleven included studies, based on the random-effects model, the estimation of the pooled prevalence of Toxocara spp. was 20.8% (95% CI, 9.8-38.7%). The association between the risk factors of toxocariasis and the prevalence of the disease was not statistically significant. Conclusions In the present study, significant prevalence was reported; however, considering the limited number of studies, it seems that the actual prevalence of the disease is higher. Therefore, it seems necessary to monitor this health problem in pregnant women.
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Affiliation(s)
- Sara Shayanfar
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Saeed Bahadory
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Taghipour
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Masoud Foroutan
- Department of Basic Medical Sciences, Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran
| | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
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Foroutan M, Vafae Eslahi A, Soltani S, Kamyari N, Moradi-Joo E, Magnaval JF, Badri M. Seroprevalence and Potential Risk Factors of Toxocariasis among General Population in Southwest Iran: Implications on the One Health Approach. J Immunol Res 2024; 2024:4246781. [PMID: 38380080 PMCID: PMC10878754 DOI: 10.1155/2024/4246781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 01/05/2024] [Accepted: 02/07/2024] [Indexed: 02/22/2024] Open
Abstract
Toxocariasis is one of the most common zoonotic diseases distributed worldwide. This study aimed to estimate the seroprevalence of anti-Toxocara immunoglobulin G (IgG) antibodies and the associated risk factors among general populations living in urban and rural areas of Abadan and Khorramshahr cities in Khuzestan Province, Southwest Iran. This cross-sectional study was conducted between March and September 2022. There were 363 participants (190 females and 173 males) aged from <20 to ≥60 years old. Anti-Toxocara IgG antibodies in serum samples were measured using a commercially available enzyme-linked immunosorbent assay (ELISA). A structured questionnaire was employed to collect information regarding sociodemographic status and probable risk factors associated with toxocariasis. It was found that the seroprevalence rate in males (15.0%, 95% CI = 10.47-21.11) was higher than in females (10.5%, 95% CI = 6.92-15.70). Moreover, we observed that the seroprevalence was higher in participants at younger ages compared to other age ranges (COR = 2.55, 95% CI = 0.92-7.12, p =0.073). The findings of the univariate analysis revealed that residency in rural areas (p < 0.001), using unpurified water (p < 0.001), contact with dog (p =0.002), contact with soil (p < 0.001), consumption of improperly washed vegetables (p < 0.001), and history of drinking untreated water (p < 0.001) were risk factors associated with toxocariasis. Further comprehensive studies with a focus on humans and animals should be designed in different areas of the Province. The data represented by the current study are useful to health policymakers to consider precise surveillance and effective prevention measures to control this zoonotic infection among general populations.
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Affiliation(s)
- Masoud Foroutan
- Research Center for Environmental Contaminants (RCEC), Abadan University of Medical Sciences, Abadan, Iran
- Department of Basic Medical Sciences, Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran
| | - Aida Vafae Eslahi
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Shahrzad Soltani
- Department of Basic Medical Sciences, Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran
| | - Naser Kamyari
- Department of Public Health, School of Health, Abadan University of Medical Sciences, Abadan, Iran
| | - Ehsan Moradi-Joo
- Department of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Jean-Francois Magnaval
- Department of Medical Parasitology, Faculty of Medicine, Paul Sabatier University, 37 Allees Jules-Guesde, 31000 Toulouse, France
| | - Milad Badri
- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
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Pereira ELGM, Ferreira IB, Victorino RB, Lescano SAZ, Giuffrida R, Kmetiuk LB, Biondo AW, Santarém VA. Serosurvey of Toxoplasma gondii and Toxocara spp. co-infection in pregnant women in low-income areas of Brazil. Front Public Health 2024; 12:1340434. [PMID: 38333736 PMCID: PMC10850292 DOI: 10.3389/fpubh.2024.1340434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 01/09/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction Despite human toxoplasmosis and toxocariasis having been listed among the top six most neglected parasitic zoonoses worldwide, presenting similar associated risk factors and transmission routes, few studies have been conducted in pregnant women and the consequences of concurrent infection remain to be fully established. Accordingly, the present study has serologically assessed the co-infection and associated risk factors for Toxoplasma gondii and Toxocara spp. in pregnant women, assisted by the public Unified National Health System (SUS) in southeastern Brazil. Materials and Methods Blood samples were collected and tested for IgG antibodies against Toxoplasma gondii by chemiluminescence immunoassay and against Toxocara spp. by enzyme-linked immunosorbent assay (ELISA). An epidemiological questionnaire was applied to gather socioeconomic information to assess the risk factors associated with seropositivity to toxocariasis/toxoplasmosis by univariate analysis followed by logistic regression. Results Overall, seropositivity was 69/280 (24.6, 95% CI: 19.96-30.01) for T. gondii and 56/280 (20.0, 95% CI: 15.73-25.08) for Toxocara spp. Co-infection was observed in 25/280 (8.9, 95% CI: 6.12-12.85) pregnant women, with increased odds (OR: 3.3, CI 95%: 1.77-6.14, p = 0.0002). Logistic regression revealed that a higher educational level (high school or college) significantly reduced the likelihood of co-infection seropositivity, owning cats increased the odds of toxocariasis, and older pregnant women presented significantly higher T. gondii seropositivity. Conclusion Co-infection herein highlights the importance of educational programs in the prevention of toxocariasis and toxoplasmosis in pregnant women and other high-risk populations.
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Affiliation(s)
| | | | | | | | - Rogério Giuffrida
- Graduate College in Animal Sciences, University of Western São Paulo (UNOESTE), São Paulo, Brazil
| | | | - Alexander Welker Biondo
- Graduate College of Cell and Molecular Biology, Federal University of Paraná (UFPR), Curitiba, Brazil
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Awais MM, Zahoor S, Akhtar M, Anwar MI, Shirwany ASAK, Ali MA, Bhatti MS, Razzaq A. Prevalence of antibodies to Toxocara canis and its associated risk factors in socio-economically deprived nomadic communities of Pakistan. Zoonoses Public Health 2023; 70:616-626. [PMID: 37381108 DOI: 10.1111/zph.13070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/17/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023]
Abstract
Toxocariasis is an important zoonotic disease caused by Toxocara (T.) canis with considerably higher prevalence in developing countries. The data on its epidemiology, especially in socioeconomically deprived nomadic communities, are scarce in Pakistan. Therefore, this study was conducted to determine the prevalence of anti-T. canis antibodies and its associated risk factors in nomadic communities located in and around Multan, Pakistan. A total of 184 sera samples were collected from nomadic communities by simple random sampling technique. The descriptive epidemiological data of participants were collected on well-designed questionnaires. Prior consent was also obtained from the participants to use the data generated from their samples without showing their identity. All the samples were analysed for the detection of anti-T. canis antibodies using commercially available Enzyme-Linked-Immunosorbent-Assay (ELISA) kits having 91% sensitivity and 96% specificity (Bordier Affinity Products, Switzerland). The overall seroprevalence of toxocariasis among nomadic communities was 27.7% (51/184). Various factors, including age, known disease history, nutritional status, contact with dogs, practice of hand washing after contact with dogs, use of unwashed vegetables, body mass index, and drug abuse, showed significant correlation (p < 0.05) with toxocariasis in nomadic communities. Conversely, other factors, including gender, marital status, educational status, awareness about zoonotic diseases, source of drinking water, occupation, location, hand washing before taking food, exposure to soil, and hygienic eating behaviour, showed non-significant correlation (p > 0.05) with seroprevalence of toxocariasis. Results also showed that >50% of seropositive cases were asymptomatic, whereas cough and abdominal pain were recorded in 19.6% and 11.76% of seropositive cases, respectively. Keeping in view, it is suggested to conduct surveys at mass level to rule out the exact disease status at national level and to include nomadic communities in local, national, and regional disease control programs through provision of better healthcare facilities and awareness about the disease.
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Affiliation(s)
- Mian Muhammad Awais
- Department of Pathobiology, Faculty of Veterinary Sciences, One Health Research Laboratory, Bahauddin Zakariya University, Multan, Pakistan
| | - Seemab Zahoor
- Department of Pathobiology, Faculty of Veterinary Sciences, One Health Research Laboratory, Bahauddin Zakariya University, Multan, Pakistan
| | - Masood Akhtar
- Department of Pathobiology, Faculty of Veterinary Sciences, One Health Research Laboratory, Bahauddin Zakariya University, Multan, Pakistan
| | - Muhammad Irfan Anwar
- Department of Pathobiology, Faculty of Veterinary Sciences, One Health Research Laboratory, Bahauddin Zakariya University, Multan, Pakistan
| | - Abdul Sammad Ali Khan Shirwany
- Department of Pathobiology, Faculty of Veterinary Sciences, One Health Research Laboratory, Bahauddin Zakariya University, Multan, Pakistan
| | - Muhammad Amjad Ali
- Department of Clinical Sciences, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | | | - Abdul Razzaq
- Animal Sciences Division, Pakistan Agricultural Research Council, Islamabad, Pakistan
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Said A, Khattak I, Abbas RZ, Khan MK, Saleemi MK, Budke CM, Verocai GG. Toxocara canis seropositivity in different exposure groups in the Khyber Pakhtunkhwa province of Northwest Pakistan. Parasitol Res 2023; 122:1159-1166. [PMID: 36890297 PMCID: PMC9995258 DOI: 10.1007/s00436-023-07816-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/02/2023] [Indexed: 03/10/2023]
Abstract
Human toxocariasis is a highly prevalent zoonosis worldwide but is underreported in most countries. This study was conducted to evaluate Toxocara canis seropositivity in different exposure sub-groups located in the Mardan, Swabi, and Nowshera districts of the Khyber Pakhtunkhwa province of Northwest Pakistan. A total of 400 blood samples were collected from males 15 years of age and older with no animals, with livestock, with dogs and/or cats living in the house, and from butchers and veterinarians or para-veterinarians. Serum was tested using a commercial ELISA kit for detection of IgG antibodies against T. canis. Proportion seropositive was presented for each group and differences between groups were evaluated using the chi-square or Fisher's exact test as appropriate. Possible risk factors obtained through administration of a questionnaire were also evaluated for each sub-population. Overall T. canis seroprevalence was 14.2%, with a significant difference found between the seroprevalence of individuals with no animals (5.0%; 5/100), individuals with dogs and/or cats living in the household (8.0%; 8/100), individuals with livestock (18.0%; 18/100), veterinarians or para-veterinarians (24.0%; 12/50), and butchers (28.0%; 14/50) (p < 0.001). Significant differences in seropositivity by income bracket, education level, and working in the fields were found for some sub-groups. Study findings demonstrate that certain sub-populations, in Northwest Pakistan, may be at greater risk of T. canis infection. Development and implementation of targeted preventive strategies may, therefore, be needed.
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Affiliation(s)
- Arsalan Said
- Department of Parasitology, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | - Irfan Khattak
- College of Veterinary Sciences and Animal Husbandry, Abdul Wali Khan University, Mardan, Pakistan
| | - Rao Zahid Abbas
- Department of Parasitology, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | - Muhammad Kasib Khan
- Department of Parasitology, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | | | - Christine M Budke
- Department of Veterinary Integrative Biosciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Guilherme G Verocai
- Department of Veterinary Pathobiology, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA.
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Adhikari RB, Dhakal MA, Ale PB, Regmi GR, Ghimire TR. Survey on the prevalence of intestinal parasites in domestic cats (Felis catus Linnaeus, 1758) in central Nepal. Vet Med Sci 2023; 9:559-571. [PMID: 36346533 PMCID: PMC10029910 DOI: 10.1002/vms3.999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Cats (Felis catus) are the only felines that live in close contact with humans. Since cats can act as vectors, carriers, reservoirs and definitive hosts of many gastrointestinal (GI) parasites, parasitic assessment could contribute to their survival and well-being. AIMS The current study aimed to assess the diversity and prevalence of GI parasites in domestic and feral cats from Ratnanagar in Chitwan in Central Nepal. METHODS A total of 107 fresh faecal samples of cats (90 household cats and 17 feral cats) of varied ages and sex were collected and transported to the laboratory. The copromicroscopic examination was carried out following direct wet mount, formalin-ethyl acetate sedimentation, saturated salt flotation, acid-fast staining and sporulation techniques. Furthermore, associated risk factors were evaluated to ascertain the predictor of risks for parasitic acquisition. RESULTS The current study revealed an overall 95.3% prevalence rate with a 100% rate in feral cats and 94.4% in household cats. Altogether, 18 (17 known and one unknown) different species of GI parasites were reported with the helminths (95.3%; 11 species) and the protozoa (55.1%; seven species). Besides age and sex, outdoor lifestyle, absence or unknown history of medication and hunting behaviour of the felines are the predictors of risk. Furthermore, mixed infection was comparatively higher than single infection in the faecal samples. CONCLUSIONS Cats harbour a higher prevalence and greater diversity of GI parasites, and parasitism varies with age and sex. This finding can be essential for veterinarians and public health authorities for strategic treatment and for assessing the zoonotic transmission of the parasites from these felines. Importantly, an effective medication strategy for cats and owners is recommended.
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Affiliation(s)
- Roshan Babu Adhikari
- Third Pole Conservancy, Bhaktapur, Nepal
- Nepalese Army Institute of Health Sciences (NAIHS), Kathmandu, Nepal
| | | | | | | | - Tirth Raj Ghimire
- Department of Zoology, Tri-Chandra Multiple Campus, Tribhuvan University, Kathmandu, Nepal
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Abadilla MEG, Paller VGV. T oxocara canis prevalence in soil, dog stool, and human serum samples from a rural village in Los Baños, Laguna, Philippines. J Parasit Dis 2022; 46:889-895. [PMID: 36091278 PMCID: PMC9458842 DOI: 10.1007/s12639-022-01507-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 06/03/2022] [Indexed: 11/30/2022] Open
Abstract
Toxocariasis is a zoonotic disease caused by Toxocara spp. from dogs and cats. The Philippines is among the countries recorded to have abundant stray cats and dogs; however, few studies have been done to elucidate the transmission dynamics and the potential risks associated with toxocariasis. This study was conducted in a rural village in Los Baños, Laguna, Philippines to determine the prevalence of toxocariasis among selected public schoolchildren and identify some risk factors that can contribute to the transmission dynamics of toxocariasis in the study site. To elucidate this, serum samples from 50 public school children (ages 8-13) were tested using a Toxocara canis IgG ELISA kit, while 60 randomly selected households were chosen for collection of soil and dog samples. Sixty soil and dog fecal samples were collected and processed through modified sucrose flotation technique and formalin-ethyl acetate concentration technique, respectively. Knowledge, attitudes and practices (KAP) survey was conducted per household to determine potential risk factors. Results revealed that 60% of the public-school children examined were positive for anti-Toxocara canis antibodies, while 38.3% of the soil samples and 28% of the dog fecal samples were found positive for contamination with Toxocara ova. Deworming of pets was found to be significantly correlated to risk factors of infection (p < 0.05). This study highlights the potential risks of toxocariasis infection of residents in rural communities. Strict implementation of ordinances related to responsible pet ownership as well as promotion of sanitation and hygiene should be employed.
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Affiliation(s)
- Moses Edric G. Abadilla
- Animal Biology Division, Institute of Biological Sciences, College of Arts and Sciences, University of the Philippines Los Baños, 4030 Laguna, Philippines
| | - Vachel Gay V. Paller
- Animal Biology Division, Institute of Biological Sciences, College of Arts and Sciences, University of the Philippines Los Baños, 4030 Laguna, Philippines
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The epidemiology and control of Toxocara canis in puppies. Parasite Epidemiol Control 2021; 16:e00232. [PMID: 34917784 PMCID: PMC8669357 DOI: 10.1016/j.parepi.2021.e00232] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 11/09/2021] [Accepted: 12/06/2021] [Indexed: 02/07/2023] Open
Abstract
Toxocara canis is a helminth zoonosis that is estimated to infect more than 100 million dogs and 1 billion people, mostly in the tropics. Humans can be infected by accidentally ingesting embryonated T. canis eggs from the environment or occasionally after ingesting L3 larvae from paratenic hosts. This study investigated the importance of vertical transmission and the role of puppies in the epidemiology of T. canis through the examination of fecal samples from dogs less than one year of age in Grenada, West Indies, a small island tropical developing country. Samples were stored at 4 °C or in 10% formalin until microscopic examination for helminth eggs or using a rapid antigen test for the presence of protozoan species. A knowledge, attitudes and practices study was completed among dog owners, physicians and veterinary students. Of 306 dogs less than one year of age, 147 (48%) were found to have T. canis eggs. Vertical transmission was indicated by the proportion of infected dogs increasing from 50% at two weeks of age (from in utero transmission) to 70% by 12 weeks (in utero and lactogenic transmission). After 12 weeks the positivity rate dropped rapidly with no dogs over 40 weeks of age being infected. As T. canis eggs were found in puppy feces at two weeks of age, initial treatment of puppies should begin earlier, at twelve days post-partum, than currently recommended to prevent shedding of eggs. Perhaps even more importantly, treatment of pregnant dogs, preventing vertical transmission, would have a major impact on the control of T. canis infection. Knowledge of T. canis and other zoonotic helminths such as Ancylostoma caninum was found to be low among dog owners, physicians and veterinary students. None of the dog owners treated their dogs for helminths, all were unaware of the risk of zoonoses, and only 9% picked up dog feces. Efforts to prevent vertical transmission and to increase awareness and knowledge of these zoonoses could result in reducing their public health impact.
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Adebiyi OE, Omobowale TO, Abatan MO. Neurocognitive domains and neuropathological changes in experimental infection with Trypanosoma brucei brucei in Wistar rats. Heliyon 2021; 7:e08260. [PMID: 34765779 PMCID: PMC8571699 DOI: 10.1016/j.heliyon.2021.e08260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/29/2021] [Accepted: 10/22/2021] [Indexed: 01/05/2023] Open
Abstract
Trypanosoma brucei brucei causes animal trypanosomiasis in several vertebrates and human African trypanosomiasis. Previous studies have only explored the incidence, clinical symptoms, haematology and biochemical changes associated with the disease. The behavioral manipulation hypothesis posits that parasites alter the behavior of host to increase the reproductive abilities of such parasites. Hence, the present study was carried out to investigate changes in behavior and cognition following experimental infection of T. brucei brucei in rat model. This study involved two groups of animals (uninfected control and T. brucei infected) with 8 rats per group. After confirmation of parasitaemia in the infected rats both groups were assessed to investigate if infection led to behavioral alterations and neuropathological changes using the open field, social interaction and forelimb suspension tests. Immunohistochemistry was performed on brain tissues using glial fibrillary acidic protein and anticalbindin-D28k, antibodies. We demonstrated that T. brucei infection triggered a significant decrease in exploratory activity, anxiety-like behavior, altered recognition of social novelty and reduced hanging latency in the hanging wire test. Immunohistochemistry revealed significant astrocytosis, loss of dendritic spines and reduction of Purkinje cell layer of the cerebellum. These results demonstrate that T. brucei infection induce signs of anxiety, impaired motor co-ordination with degeneration and loss of Purkinje cells.
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Affiliation(s)
| | | | - Mathew Oluwole Abatan
- Department of Veterinary Pharmacology and Toxicology, University of Ibadan, Ibadan, Nigeria
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Serosurvey of anti-Toxocara antibodies and risk factors in adolescent and adult pregnant women of southeastern Brazil. PLoS Negl Trop Dis 2021; 15:e0009571. [PMID: 34347773 PMCID: PMC8336820 DOI: 10.1371/journal.pntd.0009571] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/16/2021] [Indexed: 11/19/2022] Open
Abstract
Toxocariasis is worldwide endemic parasitic anthropozoonosis with high risk to those in in vulnerable populations and particularly during pregnancy and childhood. Although the prevalence of anti-Toxocara spp. antibodies has been extensively studied, risk factors of pregnant women of different ages remains to be established. This study was designed to i) assess the presence of anti-Toxocara spp. antibodies in pregnant women that presented to the public health system in a city of southeastern Brazil, and ii) determine the risk factors for toxocariasis in adolescent and adult pregnant women. This cross-sectional study included 280 pregnant women (71 aged up to and including 17 years [adolescents] and 209 aged 18 years and older [adults]). Pregnant women voluntarily agreed to complete a socioeconomic questionnaire and provide serum samples. Anti-Toxocara IgG antibodies were screened by Enzyme-Linked Immunosorbent Assay (ELISA). Univariable and multivariable logistic regression models were performed to assess the risks for toxocariasis. Overall, 20.7% of pregnant women were seropositive (33.8% of adolescents and 16.3% of adults). Prevalence in pregnant adolescents was 2.6-fold higher than in adults (Odds ration [OR]: 2.63; 95% CI: 1.42-4.86, p = 0.003). Multivariate analysis revealed that contact with soil (p = 0.01; OR = 4.76) and being in the first trimester of pregnancy (p = 0.03; OR = 0.17) had significantly greater risk of toxocariasis for adolescents, and attainment of elementary through middle school education level (p = 0.05; OR = 8.33) was a risk factor in adult pregnant women. Toxocariasis is likely underreported and neglected in adolescent pregnant women; this age group should always be monitored for toxocariasis and correspondent clinical signs, particularly at late pregnancy.
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Taghipour A, Habibpour H, Mirzapour A, Rostami A. Toxocara infection/exposure and the risk of schizophrenia: a systematic review and meta-analysis. Trans R Soc Trop Med Hyg 2021; 115:1114-1121. [PMID: 33822228 DOI: 10.1093/trstmh/trab056] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/05/2021] [Accepted: 03/09/2021] [Indexed: 12/24/2022] Open
Abstract
Toxocariasis is an important neglected disease that could have a role in the development of some neurological disorders, such as schizophrenia (SCZ). We performed the first systematic review and meta-analysis on observational studies to evaluate the possible association between Toxocara infection/exposure and SCZ. Systematic searching (PubMed, Scopus, Web of Science and Google Scholar) was performed, up to 15 August 2020, to identify the relevant studies. We used a random effects meta-analysis model to generate the pooled OR and 95% CIs. The research process resulted in the identification of six studies related to the subject of interest entailing 411 SCZ patients and 2047 controls. Our results demonstrated that the SCZ patients (15%; 95% CI 6.8 to 29.9%) had higher pooled seroprevalence of Toxocara infection/exposure than the control group (3.3%; 95% CI 1.1 to 9.4%), showing a significant association (pooled OR, 4.06; 95% CI 1.14 to 14.43). Our findings suggested that Toxocara infection/exposure might have an important but neglected contribution to SCZ development. However, further well-designed and large-scale observational studies are needed to illuminate this association. Because many other environmental and genetic factors may be strong confounders, more mechanistic/experimental studies in animal models are also necessary to further define the mechanism of this association.
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Affiliation(s)
- Ali Taghipour
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Haniyeh Habibpour
- Department of Microbiology, Islamic Azad University, Varamin Pishva Branch, Tehran, Iran
| | - Aliyar Mirzapour
- Innovative Medical Research Center, Department of Medical Parasitology and Mycology, School of Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.,Immunoregulation Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Erfani A, Pouryousef A, Arefkhah N, Shahriarirad R, Rastegarian M, Zeighami A, Mikaeili F, Hosseini SY, Sarkari B. Seroprevalence of toxocariasis and its related risk factors among municipal street sweepers in Shiraz District in Fars Province, southern Iran. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2019.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Gale SD, Hedges DW. Neurocognitive and neuropsychiatric effects of toxocariasis. ADVANCES IN PARASITOLOGY 2020; 109:261-272. [PMID: 32381201 DOI: 10.1016/bs.apar.2020.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Caused by the neuroinvasive nematodes Toxocara canis and Toxocara cati, human toxocariasis has a worldwide distribution with seroprevalence in humans associated with low socioeconomic status and low educational attainment. Third-stage Toxocara larvae can invade human tissues, including the brain and spine, where they can result in encephalitis, meningitis, and inflammation. Toxocara infection in animal models has been associated with cognitive and behavioural changes. In humans, preliminary cross-sectional research suggests that Toxocara seropositivity is associated with worse cognitive function in children and adults. Additional preliminary cross-sectional findings suggest associations between Toxocara seropositivity and neuropsychiatric function, including schizophrenia and neurologic conditions such as epilepsy. Given the widespread distribution of human toxocariasis and early evidence suggesting that it can be associated with cognitive and neuropsychiatric function in humans, additional research regarding the effects of toxocariasis on the human brain is required.
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Affiliation(s)
- Shawn D Gale
- Department of Psychology, Brigham Young University, Provo, UT, United States; The Neuroscience Centre, Brigham Young University, Provo, UT, United States.
| | - Dawson W Hedges
- Department of Psychology, Brigham Young University, Provo, UT, United States; The Neuroscience Centre, Brigham Young University, Provo, UT, United States
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Wang S, Li H, Yao Z, Li P, Wang D, Zhang H, Xie Q, Zhang Z, Li X. Toxocara infection: seroprevalence and associated risk factors among primary school children in central China. ACTA ACUST UNITED AC 2020; 27:30. [PMID: 32374716 PMCID: PMC7202827 DOI: 10.1051/parasite/2020028] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 04/21/2020] [Indexed: 11/15/2022]
Abstract
Toxocariasis is a zoonotic disease that poses a threat to public health worldwide. In the present study, we investigated the seroprevalence of Toxocara infection among primary school children in Henan province, central China, which was previously unknown. Sera from 2451 primary school children were collected from September 2015 to October 2018, and evaluated for anti-Toxocara antibodies by enzyme-linked immunosorbent assay (ELISA). The overall seroprevalence of Toxocara infection was 5.14% (126/2451). The main risk factors related to Toxocara infection identified in this study were the age of children, residence area of children, contact with cats or dogs, and exposure to soil. Hand washing before eating was considered to be a protective factor. These findings demonstrate that Toxocara infection is relatively common among primary school children in Henan province.
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Affiliation(s)
- Shuai Wang
- Xinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003 Henan, PR China
| | - Haoran Li
- Xinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003 Henan, PR China
| | - Zhijun Yao
- Xinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003 Henan, PR China
| | - Pengju Li
- Xinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003 Henan, PR China
| | - Dong Wang
- Xinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003 Henan, PR China
| | - Haizhu Zhang
- Xinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003 Henan, PR China
| | - Qing Xie
- Xinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003 Henan, PR China
| | - Zhenchao Zhang
- Xinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003 Henan, PR China
| | - Xiangrui Li
- Xinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, 453003 Henan, PR China - MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, 210095 Jiangsu, PR China
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Ma G, Rostami A, Wang T, Hofmann A, Hotez PJ, Gasser RB. Global and regional seroprevalence estimates for human toxocariasis: A call for action. ADVANCES IN PARASITOLOGY 2020; 109:275-290. [PMID: 32381202 DOI: 10.1016/bs.apar.2020.01.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Human toxocariasis is a parasitic disease transmitted usually from dogs and/or cats that are infected with Toxocara species, and can be associated with a range of allergic, neurological and/or visual disorders. Recent epidemiological research has estimated that ~1.4 billion people worldwide, particularly in subtropical and tropical regions, are infected with, or exposed to Toxocara species, indicating that human toxocariasis is a neglected tropical disease. Here, we review recent research efforts, consider risk factors, discuss limitations in current seroprevalence estimates, and propose some future research directions towards improved awareness, surveillance, prevention and control of this neglected disease.
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Affiliation(s)
- Guangxu Ma
- Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Tao Wang
- Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Andreas Hofmann
- Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Peter J Hotez
- Texas Children's Hospital Center for Vaccine Development, Departments of Pediatrics and Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States; Department of Biology, Baylor University, Waco, TX, United States; Hagler Institute for Advanced Studies at Texas A&M University, College Station, TX, United States
| | - Robin B Gasser
- Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, VIC, Australia.
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Ikotun K, Sowemimo O, Chou CM, Ajenifuja K, Chuang TW, Asaolu S, Akinwale O, Gyang V, Nwafor T, Henry E, Fan CK. High seroprevalence of Toxocara antibodies in pregnant women attending an antenatal clinic at a university hospital in Ile-Ife, Nigeria. Trans R Soc Trop Med Hyg 2020; 114:301-307. [PMID: 31925444 DOI: 10.1093/trstmh/trz116] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 10/09/2019] [Accepted: 05/11/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Human toxocariasis is a neglected zoonotic disease and its impact on human health is underestimated. Studies investigating the occurrence of toxocariasis in pregnancy are very scarce in Nigeria. This study investigated the seroprevalence of Toxocara spp. antibodies as well as the possible risk factors in pregnant women who routinely attended an antenatal clinic in a university hospital in Ile-Ife, Osun state. METHODS Blood samples were collected from 413 participating pregnant women between October 2017 and February 2018. Epidemiological data were obtained through a structured questionnaire. The sera were screened for anti-Toxocara IgG antibodies by western blot technique based on Toxocara canis larval excretory-secretory antigens, targeting low molecular weight bands of 24-35 kDa, specifically for T. canis infection. RESULTS The overall seroprevalence was 92.49% (382/413). There was no significant difference in the seroprevalence rate of Toxocara spp. infection between pregnant women aged ≤30 y and those aged >30 y (91.63 vs 93.33%; OR 1.28, 95% CI 0.61 to 2.67, p=0.511). The seroprevalence rate increased with the number of miscarriages but there was no statistical significance (p>0.05). Moreover, no significant associations were found between Toxocara spp. seropositivity and other studied risk factors (p>0.05). CONCLUSION The high seroprevalence of Toxocara spp. in pregnant Nigerian women needs comprehensive health education regarding personal hygiene and how to avoid exposure to this parasite infection.
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Affiliation(s)
- Kemisola Ikotun
- Department of Zoology, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Oluyomi Sowemimo
- Department of Zoology, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Chia-Mei Chou
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan
| | - Kayode Ajenifuja
- Department of Obstetrics, Gynaecology And Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile - Ife, Osun State, Nigeria
| | - Ting-Wu Chuang
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan.,Tropical Medicine Division, International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Samuel Asaolu
- Department of Zoology, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Olaoluwa Akinwale
- Molecular Parasitology Research Laboratory, Department of Public Health, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Vincent Gyang
- Molecular Parasitology Research Laboratory, Department of Public Health, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Timothy Nwafor
- Molecular Parasitology Research Laboratory, Department of Public Health, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Emmanuel Henry
- Molecular Parasitology Research Laboratory, Department of Public Health, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Chia-Kwung Fan
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan.,Tropical Medicine Division, International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan
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17
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Zheng WB, Zou Y, Liu GH, Zhu XQ. Epidemiology of Toxocara spp. in dogs and cats in mainland China, 2000-2019. ADVANCES IN PARASITOLOGY 2020; 109:843-860. [PMID: 32381229 DOI: 10.1016/bs.apar.2020.01.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Toxocariasis is a neglected parasitic zoonosis. Although some studies have reported the Toxocara prevalence in dogs and cats in mainland China, there is a lack of comprehensive analysis of these data. Here, we conducted the first systematic review based on relevant literatures published in Web of Science, PubMed and CNKI from January 2000 to July 2019 to assess the prevalence of Toxocara infection in dogs and cats in mainland China. A total of 68 eligible papers were retrieved, including 24,490 dogs and 844 cats, with 17.34% (4246/24,490) Toxocara canis prevalence in dogs and 22.04% (186/844) Toxocara cati prevalence in cats by faecal floatation method. The prevalence and risk factors of T. canis and T. cati infection in different geographical regions, years, breeds, ages and genders were estimated in this review. This review indicates that there was high prevalence of Toxocara infection in dogs and cats in China. This finding calls for measures to reduce the potential risk of Toxocara infection and toxocariasis in humans and animals.
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Affiliation(s)
- Wen-Bin Zheng
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China; Hunan Provincial Key Laboratory of Protein Engineering in Animal Vaccines, College of Veterinary Medicine, Hunan Agricultural University, Changsha, China
| | - Yang Zou
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Guo-Hua Liu
- Hunan Provincial Key Laboratory of Protein Engineering in Animal Vaccines, College of Veterinary Medicine, Hunan Agricultural University, Changsha, China
| | - Xing-Quan Zhu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China; Hunan Provincial Key Laboratory of Protein Engineering in Animal Vaccines, College of Veterinary Medicine, Hunan Agricultural University, Changsha, China.
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Abstract
Toxocara sp. are zoonotic parasitic roundworms that cause infection and morbidity in both developed and developing countries. In humans, infection is thought to be most common in children, particularly those living in poverty, and usually results from consumption of soil contaminated with parasite eggs deposited by dog or cat faeces. Infection in humans results in different clinical manifestations, some more overt like visceral or ocular larva migrans and others more cryptic like neurocognitive delay. Despite its pervasiveness, toxocariasis has become a neglected infection. We review the dynamics of the human-animal interface in the context of this parasite, discuss the challenges in controlling transmission to humans, and cite key areas of research that could enable improved interventions. With political will and proper resource allocation, we propose that effective interventions are possible in the near term.
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Nijsse R, Overgaauw P, Ploeger H, Mughini-Gras L. Sources of environmental contamination with Toxocara spp.: An omnipresent parasite. ADVANCES IN PARASITOLOGY 2020; 109:585-614. [PMID: 32381219 DOI: 10.1016/bs.apar.2020.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Embryonated Toxocara eggs in the environment are considered to be the most important source of human toxocariasis. These eggs, however, are also a source of infection for the definitive and paratenic hosts. Most available literature focuses on Toxocara canis in dogs, or other canids. There are, however, other Toxocara species with their accompanying definitive hosts. Results from studies that modelled patent infections in dogs, cats and foxes show that although dogs are a very important source for environmental contamination with Toxocara eggs, other sources cannot be ignored. For a good understanding of the relative contributions of different definitive hosts to environmental contamination with Toxocara eggs, computational models should be built and fed with data from different fields of expertise as is discussed in this paper.
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Affiliation(s)
- Rolf Nijsse
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
| | - Paul Overgaauw
- Division of Veterinary Public Health, Faculty of Veterinary Medicine, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Harm Ploeger
- Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Lapo Mughini-Gras
- Division of Veterinary Public Health, Faculty of Veterinary Medicine, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; National Institute for Public Health and the Environment, Centre for Infectious Disease Control (CIb), Bilthoven, The Netherlands
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20
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Kong L, Peng HJ. Current epidemic situation of human toxocariasis in China. ADVANCES IN PARASITOLOGY 2020; 109:433-448. [PMID: 32381211 DOI: 10.1016/bs.apar.2020.01.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Toxocariasis is a worldwide-distributed helminthic zoonosis, which mainly results from ascarid nematodes Toxocara canis and Toxocara cati. Humans become infected by accidental ingestion of infective eggs, raw or undercooked meat containing larvae. Keeping and contacting cats and dogs, and bad hygiene situations or habits are the main risk factors for Toxocara infection in China. The seroprevalence of Toxocara spp. is reported from 12.14% to 44.83%, and the overall seroprevalence in children was 12.14% in 1993 and elevated to 19.3% in 2015. Among the 103 cases reported in China during 1983-2019, ocular larva migrans (OLM), visceral larva migrans (VLM), and neural larva migrans (NLM) occupied 92.23%, 6.80%, and 0.97% of cases, respectively. The diagnosis of toxocariasis is mainly based on the history of exposure to infective eggs or larvae, clinical manifestations, laboratory examinations, and imaging studies. As most individuals who are infected with larval Toxocara, are unaware of their infections, patients with mild signs as described under covert toxocariasis (CT) can recover spontaneously, and treatment may not be necessary. Albendazole is the preferred treatment for patients with VLM; steroids, such as prednisolone combined with albendazole, are frequently used in treating patients with OLM, and surgery serves as an alternative treatment; thiabendazole is effective in treating patients with NLM. The true number of cases and prevalence of toxocariasis in China seems to be underestimated and neglected because of the lack of population-based epidemiological studies and insufficient clinical awareness of this disease, which are aspects that need to be improved by the Chinese government.
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Affiliation(s)
- Ling Kong
- Department of Pathogen Biology, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Hong-Juan Peng
- Department of Pathogen Biology, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China.
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Rostami A, Riahi SM, Holland CV, Taghipour A, Khalili-Fomeshi M, Fakhri Y, Omrani VF, Hotez PJ, Gasser RB. Seroprevalence estimates for toxocariasis in people worldwide: A systematic review and meta-analysis. PLoS Negl Trop Dis 2019; 13:e0007809. [PMID: 31856156 PMCID: PMC6922318 DOI: 10.1371/journal.pntd.0007809] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/25/2019] [Indexed: 12/11/2022] Open
Abstract
Background Human toxocariasis is an important neglected disease. We performed a systematic review and meta-analysis study to estimate the global and regional prevalence of anti-Toxocara serum antibodies (referred to as ‘T-seroprevalence’) in human populations around the world. Methods We searched five international databases (PubMed, EMBASE, Web of Science, SciELO and Scopus) for seroprevalence studies published from 1 January 1980 to 15 March 2019. We used random effect models to calculate the overall T-seroprevalence (with 95% CIs) in all six WHO regions and worldwide. We also conducted subgroup and linear meta-regression analyses to evaluate the impact of socio-demographic, geographical and climatic parameters on seroprevalence. Results We identified 250 eligible studies (253 datasets) comprising 265,327 participants in 71 countries for inclusion in the present meta-analysis. The estimated global T-seroprevalence rate was 19.0% (95%CI, 16.6–21.4%; 62,927/265,327); seroprevalence was highest in the African region (37.7%; 25.7–50.6%) and lowest in the Eastern Mediterranean region (8.2%; 5.1–12.0%). The pooled seroprevalence for other WHO regions was 34.1% (20.2–49.4%) in the South-East Asia; 24.2% (16.0–33.5%) in the Western Pacific; 22.8% (19.7–26.0%) in the American; and 10.5% (8.5–12.8%) in the European regions. A significantly higher T-seroprevalence was associated with a lower income level; lower human development index (HDI); lower latitude; higher humidity; higher temperature; and higher precipitation (P-value < 0.001). Potential risk factors associated with seropositivity to Toxocara included male gender; living in a rural area; young age; close contact with dogs, cats or soil; consumption of raw meat; and the drinking of untreated water. Conclusions The present findings indicate high levels of infection with, or exposure to Toxocara spp. in many countries, which calls for increased attention to human toxocariasis and improved measures to prevent adverse health risks of this disease. There have been many epidemiological studies on the seroprevalence of Toxocara infection or toxocariasis in humans in individual countries, but there has been no systematic review/meta-analysis to estimate the extent of Toxocara infection or exposure in human populations worldwide. By reviewing 250 studies of 265,327 people from 71 countries, we provide the first comprehensive global estimates of T-seroprevalence in humans to date. The findings indicate that almost one fifth (19%) of the world’s human population is seropositive to Toxocara. The highest seroprevalence rates were found in Africa (37.7%) and the lowest in the Eastern Mediterranean region (8.2%). Individual countries with high HDIs and high income levels usually had low T-seroprevalence rates. Our findings also showed that T-seroprevalence varies markedly among countries, according to geographical location (coordinates) and climatic features. Evidence from this study indicates that human toxocariasis is a prevalent, neglected tropical disease and potentially one of major importance to global public health. Our study emphasizes the need for governmental authorities to pay increased attention to the risks and socioeconomic impact of HT in many countries around the world, and for them to design and implement HT prevention or control programs, considering risk predictors identified here.
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Affiliation(s)
- Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Immunoregulation Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- * E-mail: (AR); (RBG)
| | - Seyed Mohammad Riahi
- Cardiovascular Disease Research Center, Department of Epidemiology and Biostatistics, Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Celia V. Holland
- Department of Zoology, School of Natural Sciences, Trinity College Dublin, Dublin, Ireland
| | - Ali Taghipour
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | | | - Yadolah Fakhri
- Department of Environmental Health Engineering, School of Public Health and Safety, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Fallah Omrani
- Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Peter J. Hotez
- Texas Children’s Hospital Center for Vaccine Development, National School of Tropical Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
- Department of Biology, Baylor University, Waco, Texas, United States of America
| | - Robin B. Gasser
- Department of Veterinary Biosciences, Melbourne Veterinary School, The University of Melbourne, Parkville, VIC, Australia
- * E-mail: (AR); (RBG)
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Daré LO, Bruand PE, Gérard D, Marin B, Lameyre V, Boumédiène F, Preux PM. Associations of mental disorders and neurotropic parasitic diseases: a meta-analysis in developing and emerging countries. BMC Public Health 2019; 19:1645. [PMID: 31805904 PMCID: PMC6896488 DOI: 10.1186/s12889-019-7933-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 11/11/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Although they are declining worldwide, neurotropic parasitic diseases are still common in developing and emerging countries. The aim of this study was to estimate the pooled prevalence and pooled association measures of comorbidities between mental disorders (anxiety, depression, bipolar disorder, and schizophrenia) and neurotropic parasitic diseases (malaria, cysticercosis, toxoplasmosis, human African trypanosomiasis, Chagas disease, and human toxocariasis) in developing and emerging countries. METHODS As the first meta-analysis on this topic, this study was performed in accordance with PRISMA guidelines. The protocol was registered in PROSPERO (N°CRD42017056521). The Medline, Embase, Lilacs, and Institute of Epidemiology and Tropical Neurology databases were used to search for articles without any restriction in language or date. We evaluated the quality of studies independently by two investigators using the Downs and Black assessment grid and pooled estimates using the random-effects method from CMA (Comprehensive Meta Analysis) Version 3.0. RESULTS In total, 18 studies published between 1997 and 2016 met our inclusion criteria. We found that the prevalence of anxiety and depression in people suffering from Chagas disease and/or neurocysticercosis was 44.9% (95% CI, 34.4-55.9). In 16 pooled studies that included 1782 people with mental disorders and 1776 controls, toxoplasmosis and/or toxocariasis were associated with increased risk of schizophrenia and/or bipolar disorders (odds ratio = 2.3; 95% CI, 1.7-3.2). Finally, toxocariasis and/or toxoplasmosis were associated with an increased risk of the onset of schizophrenia (odds ratio = 2.4; 95% CI, 1.7-3.4). CONCLUSION Our pooled estimates show that the associations between diseases studied are relatively high in developing and emerging countries. This meta-analysis supports the hypothesis that toxoplasmosis could be the cause of schizophrenia. These findings could prove useful to researchers who want to further explore and understand the associations studied.
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Affiliation(s)
- Labanté Outcha Daré
- INSERM, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, University of Limoges, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000 Limoges, France
| | - Pierre-Emile Bruand
- Access to Medicines, Sanofi, SAG / CSVB, 82 AV Raspail, 94250 Gentilly, France
| | - Daniel Gérard
- Access to Medicines, Sanofi, SAG / CSVB, 82 AV Raspail, 94250 Gentilly, France
| | - Benoît Marin
- INSERM, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, University of Limoges, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000 Limoges, France
| | - Valerie Lameyre
- INSERM, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, University of Limoges, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000 Limoges, France
| | - Farid Boumédiène
- INSERM, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, University of Limoges, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000 Limoges, France
| | - Pierre-Marie Preux
- INSERM, CHU Limoges, UMR_S 1094, Tropical Neuroepidemiology, University of Limoges, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, F-87000 Limoges, France
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Raissi V, Sohrabi Z, Getso M, Raiesi O, Hashemi Hafshejani S, Shabandoust H, Etemadi S. Risk factors and prevalence of toxocariasis in pregnant women and diabetic patients compared to healthy adults in Ilam province, western Iran. EXCLI JOURNAL 2018; 17:983-988. [PMID: 30564078 PMCID: PMC6295622 DOI: 10.17179/excli2018-1630] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 10/09/2018] [Indexed: 12/22/2022]
Abstract
Toxocara is one of the common intestinal nematodes in dogs and cats and is the agent of tissue migratory larvae in humans. Customarily, the prevalence of human toxocariasis hovers around 15.8 % in Iran. Furthermore, other research outcomes demonstrated a tendency for an outbreak of toxocariasis in Iran. Therefore, we carried out a cross-sectional study and assessed the seroprevalence of toxocariasis humans in Ilam Province, western of Iran. A total of 539 serum samples were collected between September 2017 and March 2018 from patients referred to the Health Centers of Ilam province, Iran. Serum samples were investigated for the presence of Toxocara using IgG antibodies, ELISA (Enzyme-Linked Immunosorbent Assay) kit. Risk factors such as contact with cats and dogs, living in rural areas were investigated among the study population. Out of 539 total samples collected, 97 cases (17.99 %) were positive for anti-toxocara IgG antibodies. These antibodies were recovered from serum samples of otherwise healthy adults (15.54 %, 49/296), pregnant women (21.16 %, 40/189) and diabetic patients (14.81 %, 8/54). This study showed significant relationship between toxocariasis and contact with animal pets in all studied groups (P value ≤ 0.05) and a significant relationship between toxocariasis and living in rural areas among pregnant women (P value ≤ 0.05).
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Affiliation(s)
- Vahid Raissi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Sohrabi
- Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Muhammad Getso
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Raiesi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeideh Hashemi Hafshejani
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hajar Shabandoust
- Department of Parasitology and Mycology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Soudabeh Etemadi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Sarkari B, Alirezaei R, Layegh Gigloo A, Rezaei Z, Mikaeili F, Bahreini MS, Fararouei M. Seroprevalence and risk factors for Toxocara
infection among children in a rural community in Fars province, southern Iran. Parasite Immunol 2018; 40:e12582. [DOI: 10.1111/pim.12582] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 08/10/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Bahador Sarkari
- Department of Parasitology and Mycology; School of Medicine; Shiraz University of Medical Sciences; Shiraz Iran
- Basic Sciences in Infectious Diseases Research Center; Shiraz University of Medical Sciences; Shiraz Iran
| | - Roya Alirezaei
- Department of Parasitology and Mycology; School of Medicine; Shiraz University of Medical Sciences; Shiraz Iran
| | - Akram Layegh Gigloo
- Department of Parasitology and Mycology; School of Medicine; Shiraz University of Medical Sciences; Shiraz Iran
| | - Zahra Rezaei
- Department of Parasitology and Mycology; School of Medicine; Shiraz University of Medical Sciences; Shiraz Iran
| | - Fataneh Mikaeili
- Department of Parasitology and Mycology; School of Medicine; Shiraz University of Medical Sciences; Shiraz Iran
| | - Mohammad Saleh Bahreini
- Department of Parasitology and Mycology; School of Medicine; Shiraz University of Medical Sciences; Shiraz Iran
| | - Mohammad Fararouei
- Department of Epidemiology; School of Health; Shiraz University of Medical Sciences; Shiraz Iran
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Frequency of Toxocara spp. antibodies in umbilical cords of newborns attended atthe University Hospital in Southern Brazil and factors associated with infection. Acta Trop 2017; 170:43-47. [PMID: 28188768 DOI: 10.1016/j.actatropica.2017.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 12/13/2016] [Accepted: 02/03/2017] [Indexed: 11/22/2022]
Abstract
Toxocariasis is a neglected and geographically widespread parasitic disease. The detection of specific antibodies associated with this disease is required to confirm its clinical diagnosis and to aid in prevention. Although helminth infection during pregnancy can promote foetal immune responses with long-term effects, specific information regarding the risk of Toxocara spp. infection to the human foetus during pregnancy is lacking. Therefore, the present study aimed to investigate the frequency of antibodies against Toxocara spp. in umbilical cord serum samples to determine the neonatal risk factors associated with Toxocara spp. infection. A cross-sectional study of the frequency of specific antibodies against Toxocara spp. was performed on umbilical cord samples of 280 neonates. A cord blood sample was obtained from each newborn after parturition, and serum samples were examined by enzyme-linked immunoassay. Epidemiological data were obtained through a questionnaire regarding obstetric history (abortion history, premature birthhistory, and pregnancy and birth numbers), general aspects (animal contact anddiet) and socio-economic factors. The frequency of anti-Toxocara spp. IgG antibodies in the umbilical cords of neonates was 20% in serum pre-adsorbed with Ascaris spp. antigen. Family income and dog ownership were considered risk factors associated with infection. No association was found between reproductive disorders and Toxocara seropositivity. The 20% frequency rate of anti-Toxocara spp. IgG antibodies in sera from umbilical cords of newborns can be related to IgG binding at the maternal-foetal interface, requiring greater care during pregnancy. Anti-Toxocara IgM and IgE antibodies no were found in umbilical cord serum samples, indicating that no vertical transmission of these parasites occurred in this population. Studies regarding antibodies against Toxocara spp. in umbilical cord sera are important for determining neonatal exposure to these parasites.
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Zyoud SH. Global toxocariasis research trends from 1932 to 2015: a bibliometric analysis. Health Res Policy Syst 2017; 15:14. [PMID: 28231792 PMCID: PMC5324285 DOI: 10.1186/s12961-017-0178-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 02/14/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Toxocariasis is a highly prevalent parasitic disease in the tropical regions of the world, with its impact on public health being typically underestimated. To better recognise the trends and characteristics of toxocariasis research, this study is a bibliometric analysis of the global toxocariasis research. METHODS Searches were completed on April 5, 2016, using the Scopus database. A search without any language restriction was performed to extract publications dealing with toxocariasis. Terms related to toxocariasis were used to perform a title keyword search. RESULTS A total of 2765 publications comprising 11 document types and published between 1932 and 2015 were included in the analysis. Articles were the most popular document form, accounting for 83.62% of all publications, followed by letters (3.80%) and reviews (3.4%). The annual number of research publications increased from 30 in 1980 to 111 in 2015, indicating that the number of publications on toxocariasis has increased slowly over the past 35 years. The United States of America and Japan are the predominant countries of origin, with 303 articles and 207 articles, respectively, followed by Brazil and the United Kingdom, with 180 (6.5%) each. The h-index for all the publications was 60. The highest h-index were for publications from the United Kingdom (h-index value = 43) and the United States (h-index value = 39); these two countries were also involved with the highest number of international collaborations, with 27 and 28 countries, respectively. CONCLUSIONS Developed countries, including the United States, Japan, the United Kingdom, France, Germany and Italy, are the world's leaders in toxocariasis research, contributing to more than 34% of the total published literature. In addition, developing countries, such as Brazil, Poland, Argentina and India, showed a noticeable increase in published papers on toxocariasis research in recent years. A push for more collaboration is needed to achieve a superior research strategy related to toxocariasis at the global level from the viewpoint of epidemiological data, clinical aspects, medical ecology, molecular aspects and treatment practices associated with toxocariasis.
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Affiliation(s)
- Sa'ed H Zyoud
- Division of Clinical and Community Pharmacy, Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Poison Control and Drug Information Center (PCDIC), Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
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Gao X, Wang H, Li J, Qin H, Xiao J. Influence of land use and meteorological factors on the spatial distribution of Toxocara canis and Toxocara cati eggs in soil in urban areas. Vet Parasitol 2017; 233:80-85. [DOI: 10.1016/j.vetpar.2016.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 11/24/2016] [Accepted: 12/09/2016] [Indexed: 11/30/2022]
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Gabrielli S, Tasić-Otašević S, Ignjatović A, Fraulo M, Trenkić-Božinović M, Momčilović S, Cancrini G. Seroprevalence and Risk Factors for Toxocara canis Infection in Serbia During 2015. Foodborne Pathog Dis 2016; 14:43-49. [PMID: 27893948 DOI: 10.1089/fpd.2016.2190] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We report data on the Toxocara seroprevalence evidenced in 2015 from samples of 40 children and 298 adults of the population living in different areas of Serbia, and on possible association of certain variables with infection. Detection of specific antibodies was performed using an enzyme-linked immunosorbent assay; all ambiguous results and part of the positive and negative sera were further analyzed by confirmatory Western blot test. An overall 23.5% seroprevalence was noticed, which was confirmed in 13.0% of the examined population with no significant difference regarding the age (children = 10.0%; adults = 13.4%) or by country area (East = 18.2%; North = 15.5%, Southeastern = 9.5%; p = 0.005). In contrast, the group of adult women proved more reactive than men (p = 0.001), and subjects both who spend spare time in square/parks (p = 0.041) and with positive onychophagy (p = 0.001) habit turned out more exposed to the infection. Possible reasons of these differences were analyzed, and the medical, veterinary, and economic impact of this soil-transmitted zoonosis were discussed.
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Affiliation(s)
- Simona Gabrielli
- 1 Department of Public Health and Infectious Diseases, "Sapienza" University of Rome , Rome, Italy
| | - Suzana Tasić-Otašević
- 2 Department of Microbiology and Immunology, Faculty of Medicine, University of Niš , Niš, Serbia .,3 Center of Microbiology and Parasitology, Public Health Institute Niš , Niš, Serbia
| | - Aleksandra Ignjatović
- 3 Center of Microbiology and Parasitology, Public Health Institute Niš , Niš, Serbia .,4 Department of Medical Statistics, Faculty of Medicine, University of Niš , Niš, Serbia
| | - Maurizio Fraulo
- 1 Department of Public Health and Infectious Diseases, "Sapienza" University of Rome , Rome, Italy
| | | | - Stefan Momčilović
- 2 Department of Microbiology and Immunology, Faculty of Medicine, University of Niš , Niš, Serbia
| | - Gabriella Cancrini
- 1 Department of Public Health and Infectious Diseases, "Sapienza" University of Rome , Rome, Italy
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29
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Kang YH, Cong W, Qin SY, Shan XF, Gao YH, Wang CF, Qian AD. First Report of Toxoplasma gondii, Dirofilaria immitis, and Chlamydia felis Infection in Stray and Companion Cats in Northeastern and Eastern China. Vector Borne Zoonotic Dis 2016; 16:654-8. [PMID: 27463689 DOI: 10.1089/vbz.2016.1993] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Feline vector-borne diseases have increasingly become a focus of interest in recent years. Toxoplasma gondii, Dirofilaria immitis, and Chlamydia felis are common pathogens of cats that can affect humans among different countries all over the world. However, information about prevalence of T. gondii and C. felis is available in China, but information about coinfection of T. gondii, D. immitis, and C. felis in cats is limited. Thus, this study was conducted to estimate the prevalence of these pathogens' infection among stray and companion cats in northeastern and eastern China and identify the influence of age, gender, types, and regions on seropositivity. The circulating antigens of D. immitis and specific antibodies to T. gondii and C. felis were examined using kits commercially available. The overall prevalence of T. gondii, D. immitis, and C. felis was 15.43%, 1.93%, and 9.90%, respectively. Coinfection was common, and infection with both T. gondii and C. felis was the most common coinfection (22.32%). Stray cats have significantly higher seroprevalences than companion cats (p < 0.05). Moreover, the infection rates of these pathogens keep increasing year by year. This is the first report of T. gondii, D. immitis, and C. felis infection in cats in northeastern and eastern China. The findings of this study reveal that T. gondii, D. immitis, and C. felis are prevalent in stray and companion cats in northeastern China, which provided baseline data for the effective prevention and control of these parasites' prevalence in these regions and other parts of China.
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Affiliation(s)
- Yuan-Huan Kang
- 1 College of Animal Science and Technology, Jilin Agricultural University , Changchun, People's Republic of China
| | - Wei Cong
- 1 College of Animal Science and Technology, Jilin Agricultural University , Changchun, People's Republic of China .,2 College of Marine Science, Shandong University at Weihai , Weihai, People's Republic of China
| | - Si-Yuan Qin
- 1 College of Animal Science and Technology, Jilin Agricultural University , Changchun, People's Republic of China .,3 General Station for Surveillance of Wildlife Diseases & Wildlife Borne Diseases, State Forestry Administration (SFA) , Shenyang, People's Republic of China
| | - Xiao-Feng Shan
- 1 College of Animal Science and Technology, Jilin Agricultural University , Changchun, People's Republic of China
| | - Yun-Hang Gao
- 1 College of Animal Science and Technology, Jilin Agricultural University , Changchun, People's Republic of China
| | - Chun-Feng Wang
- 1 College of Animal Science and Technology, Jilin Agricultural University , Changchun, People's Republic of China
| | - Ai-Dong Qian
- 1 College of Animal Science and Technology, Jilin Agricultural University , Changchun, People's Republic of China
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Seroprevalence and associated risk factors of Toxocara infection in Korean, Manchu, Mongol, and Han ethnic groups in northern China. Epidemiol Infect 2016; 144:3101-3107. [PMID: 27457773 DOI: 10.1017/s0950268816001631] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Toxocariasis is a very prevalent zoonotic disease worldwide. Recently, investigators have focused more on Toxocara spp. seroprevalence in humans. Information regarding Toxocara seroprevalence in people from different ethnic backgrounds in China is limited. For this study, blood samples were collected from a total of 802 Han, 520 Korean, 303 Manchu, and 217 Mongol subjects from Jilin and Shandong provinces. The overall Toxocara seroprevalence was 16·07% (14·21% Han, 20·58% Korean, 11·22% Manchu, 18·89% Mongol). Living in suburban or rural areas, having dogs at home, exposure to soil, and consumption of raw/undercooked meat were risk factors for Toxocara infection. Exposure to soil was identified as the major risk factor for Toxocara seropositivity in all of the tested ethnicities. To the best of our knowledge, this is the first report concerning Toxocara infection in Manchus and Mongols in China. The present study provided baseline data for effective prevention strategies of toxocariasis in northeast China and recommends improvements in personal hygiene standards to achieve this goal.
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31
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Ma G, Luo Y, Zhu H, Luo Y, Korhonen PK, Young ND, Gasser RB, Zhou R. MicroRNAs of Toxocara canis and their predicted functional roles. Parasit Vectors 2016; 9:229. [PMID: 27108220 PMCID: PMC4842261 DOI: 10.1186/s13071-016-1508-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 04/12/2016] [Indexed: 12/21/2022] Open
Abstract
Background Toxocara canis is the causative agent of toxocariasis of humans and other animals. This parasitic nematode (roundworm) has a complex life cycle, in which substantial developmental changes and switches occur. As small non-coding RNAs (sRNAs) are key regulators of gene expression in a wide range of organisms, we explored these RNAs in T. canis to provide a basis for future studies of its developmental biology as well as host interactions and disease at the molecular level. Methods We conducted high-throughput RNA sequencing and bioinformatic analyses to define sRNAs in individual male and female adults of T. canis. Results Apart from snRNA and snoRNA, 560 and 619 microRNAs (miRNAs), including 5 and 2 novel miRNAs, were identified in male and female worms, respectively, without piRNAs being detected in either sex. An analysis of transcriptional profiles showed that, of 564 miRNAs predicted as being differentially transcribed between male and female individuals of T. canis, 218 miRNAs were transcribed exclusively in male and 277 in female worms. Functional enrichment analysis predicted that both male and female miRNAs were mainly involved in regulating embryonic morphogenesis, hemidesmosome assembly and genetic information processing. The miRNAs differentially transcribed between the sexes were predicted to be associated with sex determination, embryonic morphogenesis and nematode larval development. The roles of miRNAs were predicted based on gene ontology (GO) and KEGG pathway annotations. The miRNAs Tc-miR-2305 and Tc-miR-6090 are proposed to have roles in reproduction, embryo development and larval development, and Tc-let-7-5p, Tc-miR-34 and Tc-miR-100 appear to be involved in host-parasite interactions. Together with published information from previous studies, some miRNAs (such as Tc-miR-2861, Tc-miR-2881 and Tc-miR-5126) are predicted to represent drug targets and/or associated with drug resistance. Conclusions This is the first exploration of miRNAs in T. canis, which could provide a basis for fundamental investigations of the developmental biology of the parasite, parasite-host interactions and toxocariasis as well as applied areas, such as the diagnosis of infection/disease, drug target discovery and drug resistance detection. Electronic supplementary material The online version of this article (doi:10.1186/s13071-016-1508-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Guangxu Ma
- Department of Veterinary Medicine, Rongchang Campus of Southwest University, Chongqing, 402460, The People's Republic of China.,Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Yongfang Luo
- Department of Veterinary Medicine, Rongchang Campus of Southwest University, Chongqing, 402460, The People's Republic of China
| | - Honghong Zhu
- Department of Veterinary Medicine, Rongchang Campus of Southwest University, Chongqing, 402460, The People's Republic of China
| | - Yongli Luo
- Department of Veterinary Medicine, Rongchang Campus of Southwest University, Chongqing, 402460, The People's Republic of China
| | - Pasi K Korhonen
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Neil D Young
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Robin B Gasser
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia.
| | - Rongqiong Zhou
- Department of Veterinary Medicine, Rongchang Campus of Southwest University, Chongqing, 402460, The People's Republic of China.
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32
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Eosinophilic Myocarditis due to Toxocariasis: Not a Rare Cause. Case Rep Cardiol 2016; 2016:2586292. [PMID: 27123346 PMCID: PMC4830700 DOI: 10.1155/2016/2586292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 02/28/2016] [Accepted: 03/17/2016] [Indexed: 01/01/2023] Open
Abstract
Myocarditis is a clinically important disease because of the high mortality. From the perspective of treatment strategy, eosinophilic myocarditis should be distinguished from other types of myocarditis. Toxocariasis, caused by Toxocara canis or Toxocara cati, is known as a cause of eosinophilic myocarditis but is considered rare. As it is an unpopular disease, eosinophilic myocarditis due to toxocariasis may be underdiagnosed. We experienced two cases of eosinophilic myocarditis due to toxocariasis from different geographical areas in quick succession between 2013 and 2014. Case 1 is 32-year-old man. Case 2 is 66-year-old woman. In both cases, diagnosis was done by endomyocardial biopsy and IgG-ELISA against Toxocara excretory-secretory antigen. Only a corticosteroid was used in Case 1, whereas a corticosteroid and albendazole were used in Case 2 as induction therapy. Both patients recovered. Albendazole was also used in Case 1 to prevent recurrence after induction therapy. Eosinophilic myocarditis by toxocariasis may in actuality not be a rare disease, and corticosteroid is an effective drug as induction therapy even before use of albendazole.
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Abstract
Toxocara canis and T. cati are highly prevalent nematode infections of the intestines of dogs and cats. In paratenic hosts, larvae do not mature in the intestine but instead migrate through the somatic tissues and organs of the body. The presence of these migrating larvae can contribute to pathology. Toxocara larvae can invade the brains of humans, and while case descriptions of cerebral toxocariasis are historically rare, improved diagnosis and greater awareness have contributed to increased detection. Despite this, cerebral or neurological toxocariasis (NT) remains a poorly understood phenomenon. Furthermore, our understanding of cognitive deficits due to toxocariasis in human populations remains particularly deficient. Recent data describe an enhanced expression of biomarkers associated with brain injury, such as GFAP, AβPP, transforming growth factor β1 (TGF-β1), NF-L, S100B, tTG, and p-tau, in mice receiving even low doses of Toxocara ova. Finally, this review outlines a hypothesis to explore the relationship between the presence of T. canis larvae in the brain and the progression of Alzheimer's disease (AD) due to enhanced AD-associated neurodegenerative biomarker expression.
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Cong W, Meng QF, You HL, Zhou N, Dong XY, Dong W, Wang XY, Qian AD, Zhu XQ. Seroprevalence and risk factors of Toxocara infection among children in Shandong and Jilin provinces, China. Acta Trop 2015; 152:215-219. [PMID: 26384456 DOI: 10.1016/j.actatropica.2015.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 09/05/2015] [Accepted: 09/12/2015] [Indexed: 11/18/2022]
Abstract
This cross-sectional study was aimed to investigate the Toxocara serology in children in Shandong and Jilin provinces, China using an enzyme-linked immunosorbent assay (ELISA). The overall Toxocara seroprevalence among the study population (n=1458) was 19.3%, sick children (26.4%) had significantly higher seroprevalence than clinically healthy children (14.4%) (P<0.05), and the highest Toxocara seroprevalence was found in children suffering from chronic cough (40.6%), followed by recurrent abdominal pain (40.0%), recurrent headache (38.1%), slight fever (36.2%), and recurrent vomiting (31.6%). Place of residence, education level, type of school, keeping dogs at home, contact with dogs and cats and exposure with soil were found to be associated with Toxocara infection. Our findings show that children infection with Toxocara is common in Shandong and Jilin provinces, eastern and northeastern China, indicating an immediate need for implementing strategies and measures to prevent and control Toxocara infection in children in China.
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Affiliation(s)
- Wei Cong
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, PR China; College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province 130118, PR China
| | - Qing-Feng Meng
- Jilin Entry-Exit Inspection and Quarantine Bureau, Changchun, Jilin Province 130000, PR China
| | - Hai-Long You
- The First Affilliated Hospital of Jilin University, Changchun, Jilin Province 130000, PR China
| | - Na Zhou
- Affilliated Hospital of Medical College, Qingdao University, Qingdao, Shandong Province 266000, PR China
| | - Xiao-Yan Dong
- Wendeng Stomatological Hospital, Weihai, Shandong Province 264400, PR China
| | - Wei Dong
- Weihaiwei People's Hospital, Weihai, Shandong Province 264200, PR China
| | - Xiang-Yang Wang
- Wendeng Municipal Hospital, Weihai, Shandong Province 264400, PR China
| | - Ai-Dong Qian
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province 130118, PR China
| | - Xing-Quan Zhu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, PR China.
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Lack of Association between Toxocara Exposure and Suicide Attempts in Psychiatric Patients. J Parasitol Res 2015; 2015:608604. [PMID: 26483971 PMCID: PMC4592907 DOI: 10.1155/2015/608604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/21/2015] [Accepted: 08/23/2015] [Indexed: 11/30/2022] Open
Abstract
Infection with Toxocara may affect the central nervous system. A high seroprevalence of Toxocara infection has been reported in psychiatric patients. To the best of our knowledge, there is no previous report about an association of Toxocara infection with suicide attempts. Therefore, we sought to determine whether Toxocara exposure is associated with suicide attempts in psychiatric patients. We studied 282 psychiatric outpatients (156 with suicide attempts and 126 without suicide attempts). Sera of patients were analyzed for the presence of anti-Toxocara IgG antibodies by using a commercially available enzyme immunoassay. One of the 156 (0.6%) suicide attempters and 1 (0.8%) of the 126 controls were positive for anti-Toxocara IgG antibodies (OR = 0.80; 95% CI: 0.04–13.02; P = 1.00). Toxocara seropositivity was significantly higher (P = 0.01) in male patients with consumption of raw dried goat meat than male patients without this consumption. Results suggest that Toxocara exposure is not associated with suicide attempts in psychiatric outpatients in Durango City, Mexico. However, further studies with larger samples sizes to confirm our results should be conducted. Too few patients were seropositive to assess further associations of Toxocara exposure with sociodemographic, clinical, and behavioral characteristics of the psychiatric patients.
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Ma GX, Zhou RQ, Song ZH, Zhu HH, Zhou ZY, Zeng YQ. Molecular mechanism of serine/threonine protein phosphatase 1 (PP1cα-PP1r7) in spermatogenesis of Toxocara canis. Acta Trop 2015; 149:148-54. [PMID: 26026715 DOI: 10.1016/j.actatropica.2015.05.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Revised: 05/20/2015] [Accepted: 05/25/2015] [Indexed: 01/21/2023]
Abstract
Toxocariasis is one of the most important, but neglected, zoonoses, which is mainly caused by Toxocara canis. To better understand the role of serine/threonine protein phosphatase 1 (PP1) in reproductive processes of male adult T. canis, differential expression analysis was used to reveal the profiles of PP1 catalytic subunit α (PP1cα) gene Tc-stp-1 and PP1 regulatory subunit 7 (PP1r7) gene TcM-1309. Indirect fluorescence immunocytochemistry was carried out to determine the subcellular distribution of PP1cα. Double-stranded RNA interference (RNAi) assays were employed to illustrate the function and mechanism of PP1cα in male adult reproduction. Real-time quantitative PCR (qPCR) showed transcriptional consistency of Tc-stp-1 and TcM-1309 in sperm-producing germline tissues and localization research showed cytoplasmic distribution of PP1cα in sf9 cells, which indicated relevant involvements of PP1cα and PP1r7 in spermatogenesis. Moreover, spatiotemporal transcriptional differences of Tc-stp-1 were determined by gene knockdown analysis, which revealed abnormal morphologies and blocked meiotic divisions of spermatocytes by phenotypic aberration scanning, thereby highlighting the crucial involvement of PP1cα in spermatogenesis. These results revealed a PP1cα-PP1r7 mechanism by which PP1 regulates kinetochore-microtubule interactions in spermatogenesis and provided important clues to identify novel drug or vaccine targets for toxocariasis control.
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Affiliation(s)
- Guang Xu Ma
- Department of Veterinary Medicine, Rongchang Campus, Southwest University, Chongqing 402460, People's Republic of China
| | - Rong Qiong Zhou
- Department of Veterinary Medicine, Rongchang Campus, Southwest University, Chongqing 402460, People's Republic of China.
| | - Zhen Hui Song
- Department of Veterinary Medicine, Rongchang Campus, Southwest University, Chongqing 402460, People's Republic of China
| | - Hong Hong Zhu
- Department of Veterinary Medicine, Rongchang Campus, Southwest University, Chongqing 402460, People's Republic of China
| | - Zuo Yong Zhou
- Department of Veterinary Medicine, Rongchang Campus, Southwest University, Chongqing 402460, People's Republic of China
| | - Yuan Qin Zeng
- College of Life Sciences, Southwest University, Chongqing 402460, People's Republic of China
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Santos PC, Lehmann LM, Lorenzi C, Hirsch C, Telmo PL, Mattos GT, Cadore PS, Klafke GB, Berne MEA, Gonçalves CV, Scaini CJ. The Seropositivity of Toxocara spp. Antibodies in Pregnant Women Attented at the University Hospital in Southern Brazil and the Factors Associated with Infection. PLoS One 2015; 10:e0131058. [PMID: 26146833 PMCID: PMC4492739 DOI: 10.1371/journal.pone.0131058] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 05/28/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Human toxocariasis is a parasitic zoonosis with a worldwide distribution but is underdiagnosed with an underestimated impact on human health. The ingestion of embryonated eggs of Toxocara spp. present on the hands or in contaminated food or water is the main mode of infection. The only record of Toxocara congenital infection in humans occurred in a premature infant. Helminth infections during pregnancy may be associated with reproductive disorders. Studies investigating the occurrence of toxocariasis in pregnancy are scarce, as is research on the possible implications of these parasites in reproductive health. The aim of this study was to determine the seroprevalence of antibodies to Toxocara spp. in pregnant women and to identify risk factors associated with its infection. METHODOLOGY/PRINCIPAL FINDINGS The cross-sectional study of the seropositivity of specific antibodies for Toxocara spp. was performed on 280 pregnant women. Serum samples were examined with enzyme-linked immunoassay. Epidemiological data were obtained through a questionnaire containing information about obstetric history, general life style choices, and the social and economic status of the women. The prevalence of Toxocara spp. IgG in pregnant women was 6.4%. Some of the risk factors associated with the infection were owning dogs (p = 0.003), living in the city centre (p = 0.028), living at the city beach (p = 0.003), and having a family income at or below minimum wage (p < 0.001). There was no association between reproductive disorders and Toxocara seropositivity. CONCLUSIONS/SIGNIFICANCE The seroprevalence of 6.4% for Toxocara spp. in pregnant women shows that there was exposure to the parasite. The study demonstrates the need for attention for the completion of clinical diagnosis parameters, as well as the expansion of highly specific serological studies in different regions to understand the impact of toxocariasis in pregnancy.
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Affiliation(s)
- Paula Costa Santos
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Lis Maurente Lehmann
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Carolina Lorenzi
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Carolina Hirsch
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Paula Lima Telmo
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Gabriela Torres Mattos
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Priscila Silva Cadore
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Gabriel Baracy Klafke
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
| | - Maria Elisabeth Aires Berne
- Laboratory of Parasitology, Institute of Biology, Department of Microbiology and Parasitology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Carla Vitola Gonçalves
- Obstetric Center, University Hospital of Rio Grande–Rio Grande, Rio Grande do Sul, Brazil
| | - Carlos James Scaini
- Laboratory of Parasitology, Faculty of Medicine—FAMED, Area Interdisciplinary Biomedical Sciences (AICB) Federal University of Rio Grande–FURG Rio Grande, Rio Grande do Sul, Brazil
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Prevalence and Risk Factors of Intestinal Parasites in Cats from China. BIOMED RESEARCH INTERNATIONAL 2015; 2015:967238. [PMID: 26078975 PMCID: PMC4442275 DOI: 10.1155/2015/967238] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 04/28/2015] [Accepted: 04/29/2015] [Indexed: 11/18/2022]
Abstract
The prevalence of intestinal parasites in cats from China was largely unknown prior to this study. The aim of the present study was to investigate the presence of intestinal parasites in cats from central China and also identify risk factors for parasitism. Fecal samples from 360 cats were examined using sugar flotation procedure and fecal smear test by microscope. Cats had mixed two or three kinds of parasites infections. Of the 360 cats feces, intestinal parasites positive feces were 149 (41.39%). 64 (17.78%) were infected with Toxocara cati, 61 (16.94%) with Isospora felis, 41 (11.39%) with Isospora rivolta, 33 (9.17%) with Paragonimus, 23 (6.39%) with hookworms, 11 (3.06%) with Toxoplasma-like oocysts, 10 (2.78%) with Trichuris, 4 (1.11%) with lungworm, 2 (0.56%) with Sarcocystis, and 1 (0.28%) with Trematode. The cats' living outdoor was identified as risk factor by statistical analysis. These results provide relevant basic data for assessing the infection of intestinal parasites in cats from central region of China. In conclusion, there was high prevalence of intestinal parasites in cats from China.
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SOZEN H, CITIL BE, CAYLAK S, GOKMEN AA, KAYA S, DEMIRCI M, KORKMAZ M, SAHIN C, KIRLI I. Seroepidemiological Study of Toxocariasis among Volunteers Animal Husbandry Workers and Veterinary in Southern Anatolia in Turkey in 2014. IRANIAN JOURNAL OF PARASITOLOGY 2015; 10:473-81. [PMID: 26622303 PMCID: PMC4662748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Human toxocariasis is a parasitic infection caused by the larvae of Toxocara canis. We examine the Toxocara seroprevalance in veterinarians and animal husbandry workers living in the Mugla Province, Turkey to evaluate better the risk factors for Toxocara exposure. METHODS In 2014, 376 volunteers participated in the study in 2014. All blood specimens were tested using a commercial enzyme immunoassay kit and ELISA positive samples were confirmed by Western Blot (WB) method. RESULTS The seroprevalence of Toxocara, as determined by WB, was 8%. A statistically significant correlation was evident between patient age and Toxocara positivity among animal husbandry workers (P = 0.029). A strong association was also evident between sex and seropositivity in the animal husbandry group (P=0.024). Veterinarians working in pet clinics did in fact exhibit higher Toxocara seropositivities relative to those of other groups (P = 0.029). A statistically significant difference was detected between the rural geographic areas surveyed (P = 0.04). CONCLUSION In Mugla Province, seroprevalence of Toxocara is lower than other regions. Despite the low seroprevalence observed, especially in high risk professions toxocariasis remains an important medical concern within the region.
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Affiliation(s)
- Hamdi SOZEN
- Dept. of Infectious Disease, School of Medicine, Mugla Sitki Kocman University, Mugla, Turkey,
| | - Burak E CITIL
- Dept. of Microbiology, School of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Selmin CAYLAK
- Dept. of Infectious Disease, School of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Aysegul A GOKMEN
- Dept. of Microbiology, School of Medicine, Katip Celebi University, Izmir, Turkey
| | - Selçuk KAYA
- Dept. of Microbiology, School of Medicine, Katip Celebi University, Izmir, Turkey
| | - Mustafa DEMIRCI
- Dept. of Microbiology, School of Medicine, Katip Celebi University, Izmir, Turkey
| | - Metin KORKMAZ
- Dept. of Parasitology, School of Medicine, Ege University, Izmir, Turkey
| | - Cem SAHIN
- Dept. of Internal Medicine, School of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Ismail KIRLI
- Dept. of Internal Medicine, School of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
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