Helminth Infections and Cardiovascular Diseases: Toxocara Species is Contributing to the Disease

Gastrointestinal parasites of cats in the Middle East (2000-2023): A literature review

BACKGROUND/OBJECTIVE

Gastrointestinal parasites in stray cats are of significant clinical and zoonotic importance and pose a potential threat to public health. Hence, the current review has practical implications as it aims to present the diversity and the prevalence of cat parasites in Middle Eastern countries.

METHODS

The research process was rigorous and thorough, spanning from 2000 to 2023. Data collection and analysis were conducted utilizing multiple international and national databases, including Google Scholar, Scopus, PubMed, and Irandoc. This meticulous approach ensures the reliability and validity of the findings, providing a solid foundation for further research and preventive measures.

RESULTS

A total of 159 articles were collected and comprehensively reviewed. Among these, 85 articles were from Iran, 25 from Türkiye, 20 from Iraq, 11 from Egypt, five from Qatar, three from Cyprus, three from Kuwait, and one each from the UAE, Saudi Arabia, Syria, Lebanon, Jordan, Israel, and Palestine. Toxocara cati was the most prevalent nematode, exhibiting the highest prevalence in Iran, ranging from 8% to 90%, followed by Egypt, with a range of 8.23% to 58.7%. In comparison, the lowest prevalence was recorded in Qatar at 8%. Hydatigera taeniaeformis, a common cestode in the feline, showed the highest prevalence in Qatar, with a range of 73.6% to 75.8%, while the lowest was in Kuwait at 0.8%. In Iran, the prevalence ranged from 0.9% to 64.7%. Toxoplasma gondii, a cosmopolitan protozoan, showcased the highest prevalence in Lebanon at 78.1% and the lowest in the UAE at 0.8%. In Iran, the prevalence ranged between 1.2% and 90%. Additionally, noteworthy patterns regarding the distribution and potential risk factors associated with these parasites were observed. While gender variations were not significant, environmental conditions such as high humidity and absence of sunlight exposure, along with the age and behavior of cats, were among the risk factors associated with the prevalence of parasites.

CONCLUSION

The prevalence of parasites among stray cats in Iran and other Middle Eastern countries remains notably high. This emphasizes the urgent need for a series of control and preventive measures. Implementing effective anti-parasitic strategies and emphasizing the development of multiple diagnostic methods are essential.

Toxocara Species Infection in Pet Dogs and Cats Ensured by Loop-Mediated Isothermal Amplification Assay

Background: Toxocariasis is a parasitic disease with global distribution. Many paratenic or transport hosts have been identified as the sources of infection, including vertebrates such as birds and humans. The definitive hosts of Toxocara are dogs and cats whose parasites live in their guts. Hence, the diagnosis of the disease in these animals is important. Objective: The present study was performed using the loop-mediated isothermal amplification (LAMP) method to diagnose toxocariasis. Materials and Methods: In the present study, 60 samples of pet feces were collected and subsequently evaluated by direct smear, formalin-ether, and LAMP. Results: Toxocara infection in dogs by microscopic and formal ether methods and LAMP method was 10% and 13.3%, respectively, while feline infection with this parasite was not observed either microscopically or molecularly. Conclusion: The present findings revealed that pet dogs can be considered as a source of infection for humans. Therefore, it is recommended that animal owners receive the necessary training to prevent the risks of transmitting zoonotic diseases.

A rare case of toxocariasis presenting with hypereosinophilic pericardial effusion and mycotic aneurysm

Parasitic infections are the leading cause of hypereosinophilia in the paediatric population in tropical countries. We report an unusual case of Toxocara infection in an eight-year-old boy who presented with intermittent fever, hypereosinophilia complicated by massive pericardial effusion and a mycotic aneurysm. This child received treatment with four weeks of albendazole and steroids.

Toxocariasis-Associated Acute Perimyocarditis with Cardiogenic Shock: A Case Report

Patient: Female, 21-year-old

Final Diagnosis: Toxocariasis-associated acute perimyocarditis with cardiogenic shock

Symptoms: Dizziness • epigastric pain • headache • vomiting

Medication: —

Clinical Procedure: —

Specialty: Cardiology

The prevalence of intestinal nematodes among red foxes (Vulpes vulpes) in north-western Poland

Background

The red fox (Vulpes vulpes) is widely distributed in the Northern Hemisphere and Australia. The presence of nematode-infected foxes in urbanized areas increases the risk of transmission of nematodes to domestic dogs and thus, to humans. The aim of this study was to determine the prevalence and species composition of intestinal nematodiasis in red foxes in Western Pomerania, a province in north-western Poland. The intestinal contents of 620 red foxes killed during a government reduction shooting programme were examined for adult nematodes using the sedimentation and counting technique (SCT).

Results

Intestinal nematodes, including Toxocara canis, Toxascaris leonina, Uncinaria stenocephala and Trichuris vulpis, were found in 77.3% (95% CI 73.8–80.4%) of the examined foxes with a mean infection burden of 20.1 nematode per animal. Male and female foxes had similar infection burdens.

Conclusions

The nematodes are present in high prevalence and intensity among foxes in north-western Poland. Furthermore, this high prevalence of nematodes in foxes may likely constitute a health risk to humans and domestic animals due to increasing fox densities in urban and periurban areas.

Systematic review and meta-analysis on the risk potential of zoonotic toxocariasis from soil contamination of public places in India

Parasitic zoonoses despite of their potential threats to human health remain neglected especially in developing countries. Toxocara canis and Toxocara cati worms are considered important zoonotic parasites and the ability of their infective ova to sustain longer in suitable edaphic environments poses constant risk of infection to humans. This systematic review and meta-analysis aims to highlight the burden and importance of soil borne toxocariasis in India. A total of 14 primary prevalence studies spanned over a period from 1985 to 2017 were included in this study. Due to expected variation between studies, a random-effects model was applied by using MetaXL add-on. The apparent prevalence based on the soil samples tested positive was found in the range of 2.11 to 31.0% while the weighted pooled prevalence was estimated as 11.26 (95% CI 07.59 - 15.54%). A high heterogeneity between studies (I² = 93.39 and Q = 227.024, p = 0.00) confirmed the diversity of the populations under study. This meta-analysis highlights the need of more studies on soil transmission of zoonotic toxocariasis in India.

Seroprevalence of Toxocara spp. antibodies in humans in Africa: A review

BACKGROUND

Human toxocariasis occurs worldwide and is caused by nematodes of the species of the genus Toxocara. Infection occurs by the ingestion of eggs and is usually asymptomatic or oligosymptomatic. However, severe manifestations occur. The burden of disease and its public health impact remain ill-defined. The aim of this review was to summarize all available data on the seroprevalence of toxocariasis on the African continent and factors associated with seropositivity.

METHODS

Twenty-seven original papers published between 1991 and 2017 were identified that provided data suitable for this review. Case-control studies were included and the seroprevalence in the (healthy) control group was used as a surrogate parameter.

RESULTS

Antibodies against Toxocara spp. were found to be frequent in most populations and regions in Africa with the exception of two publications, one from the Democratic Republic of the Congo and one from Djibouti, where all participants were seronegative. The highest proportion of participants with antibodies was found on the island of La Réunion with 359 out 387 study participants being positive (92.8%). Factors associated with seropositivity were reported across studies, including-among others-older age, contact with soil via geophagia, agricultural activity or playing with soil, contact with animals, especially dogs, and low socio-economic status, defined as absence of water supply or poor housing. Three Egyptian studies found male gender to be associated with toxocariasis, whereas in La Réunion females were at increased risk.

CONCLUSIONS

Exposure to toxocariasis seems to be very frequent and common in large parts of the African continent. However, no data are available for most countries. The public health impact of human toxocariasis and the frequency of severe manifestations remain unclear.

Prevalence of Toxocara and Toxascaris infection among human and animals in Iran with meta-analysis approach

BACKGROUND

Toxocariasis is a worldwide zoonotic parasitic disease caused by species of Toxocara and Toxascaris, common in dogs and cats. Herein, a meta-analysis was contrived to assess the prevalence of Toxocara/Toxascaris in carnivore and human hosts in different regions of Iran from April 1969 to June 2019.

METHODS

The available online articles of English (PubMed, Science Direct, Scopus, and Ovid) and Persian (SID, Iran Medex, Magiran, and Iran Doc) databases and also the articles that presented in held parasitology congresses of Iran were involved.

RESULTS

The weighted prevalence of Toxocara/Toxascaris in dogs (Canis familiaris) and cats (Felis catus) was 24.2% (95% CI: 18.0-31.0%) and 32.6% (95% CI: 22.6-43.4%), respectively. Also, pooled prevalence in jackal (Canis aureus) and red fox (Vulpes vulpes) was 23.3% (95% CI: 7.7-43.2%) and 69.4% (95% CI: 60.3-77.8%), correspondingly. Weighted mean prevalence of human cases with overall 28 records was 9.3% (95% CI: 6.3-13.1%). The weighted prevalence of Toxocara canis, Toxocara cati, and Toxascaris leonina was represented as 13.8% (95% CI: 9.8-18.3%), 28.5% (95% CI: 20-37.7%) and 14.3% (95% CI: 8.1-22.0%), respectively.

CONCLUSION

Our meta-analysis results illustrate a considerable prevalence rate of Toxocara/Toxascaris, particularly in cats and dogs of northern parts of Iran. The presence of suitable animal hosts, optimum climate and close contact of humans and animals would have been the reason for higher seroprevalence rates of human cases in our region. Given the significance clinical outcomes of human Toxocara/Toxascaris, necessary measures should be taken.

Toxocariasis: a silent threat with a progressive public health impact

Background

Toxocariasis is a neglected parasitic zoonosis that afflicts millions of the pediatric and adolescent populations worldwide, especially in impoverished communities. This disease is caused by infection with the larvae of Toxocara canis and T. cati, the most ubiquitous intestinal nematode parasite in dogs and cats, respectively. In this article, recent advances in the epidemiology, clinical presentation, diagnosis and pharmacotherapies that have been used in the treatment of toxocariasis are reviewed.

Main text

Over the past two decades, we have come far in our understanding of the biology and epidemiology of toxocariasis. However, lack of laboratory infrastructure in some countries, lack of uniform case definitions and limited surveillance infrastructure are some of the challenges that hindered the estimation of global disease burden. Toxocariasis encompasses four clinical forms: visceral, ocular, covert and neural. Incorrect or misdiagnosis of any of these disabling conditions can result in severe health consequences and considerable medical care spending. Fortunately, multiple diagnostic modalities are available, which if effectively used together with the administration of appropriate pharmacologic therapies, can minimize any unnecessary patient morbidity.

Conclusions

Although progress has been made in the management of toxocariasis patients, there remains much work to be done. Implementation of new technologies and better understanding of the pathogenesis of toxocariasis can identify new diagnostic biomarkers, which may help in increasing diagnostic accuracy. Also, further clinical research breakthroughs are needed to develop better ways to effectively control and prevent this serious disease.

Electronic supplementary material

The online version of this article (10.1186/s40249-018-0437-0) contains supplementary material, which is available to authorized users.

Toxocariasis in humans in Africa - A systematic review

BACKGROUND

Toxocariasis is a globally distributed zoonosis. The most important definitive hosts are dogs, whereas humans serve as paratenic hosts. Transmission to humans occurs by accidental ingestion of eggs, e.g. by consumption of contaminated fruits or vegetables. Although exposure to Toxocara is usually considered as relatively benign, it is implicated in a range of neurological, ophthalmologic and other organ-specific conditions, some of them with grave consequences. This review provides an overview on the epidemiology, presentation and risk factors of exposure to Toxocara in Africa.

METHODS

A systematic search was performed for studies published after January 1st, 1990, in English, French, Portuguese, Spanish, Dutch or German. The review was prepared according to PRISMA guidelines. Studies on toxocariasis in human populations and contamination in human environments were included.

RESULTS

Sixty-five papers were included. Antibodies against Toxocara spp. in humans were found to be very common across Africa. Severe manifestations have been reported mainly from North Africa. Environmental contamination including soil, vegetables and fruits sold on markets was demonstrated in various locations in Africa.

CONCLUSIONS

Exposure to Toxocara is prevalent across the African continent. However, the complication frequency, the impact of the condition on the individual and the public health relevance of this zoonosis, and the economic impact have never been systematically evaluated.