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Elgendy DI, Elmahy RA, Amer AIM, Ibrahim HA, Eltantawy AF, Mansour FR, Salama AM. Efficacy of artemether against toxocariasis in mice: parasitological and immunopathological changes in brain, liver, and lung. Pathog Glob Health 2024; 118:47-64. [PMID: 37978995 PMCID: PMC10769145 DOI: 10.1080/20477724.2023.2285182] [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] [Indexed: 11/19/2023] Open
Abstract
Toxocariasis is a zoonosis that represents a serious threat to public health particularly in tropical and subtropical areas. Currently, albendazole, the most effective drug for treating visceral toxocariasis, shows moderate efficacy against the larvae in tissues and has some adverse effects. Artemether is an antiparasitic drug mainly used in the treatment of malaria and showed effectiveness against numerous helminthic infections. Besides, it possesses potent anti-inflammatory, antiapoptotic, antifibrotic, and neuroprotective properties. Thus, the study's aim was to investigate artemether's effects in comparison with albendazole on the therapeutic outcome of experimental toxocariasis. For this aim, 140 laboratory-bred mice were divided into four main groups: uninfected control, treatment control, albendazole-treated, and artemether-treated groups. The treatment regimens were started at the 15th dpi (early treatment), and at the 35th dpi (late treatment). The effectiveness of treatment was determined by brain larval count, histopathological, immunohistochemical, and biochemical examination. Artemether showed more effectiveness than albendazole in reducing brain larval counts, markers of brain injury including NF-κB, GFAP, and caspase-3, the diameter and number of hepatic granulomas, hepatic oxidative stress, hepatic IL-6, and TG2 mRNA, and pulmonary inflammation and fibrosis. The efficacy of artemether was the same when administered early or late in the infection. Finally, our findings illustrated that artemether might be a promising therapy for T. canis infection and it could be a good substitution for albendazole in toxocariasis treatment.
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Affiliation(s)
- Dina I. Elgendy
- Medical Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Rasha A. Elmahy
- Zoology Department, Faculty of Science, Tanta University, Tanta, Egypt
| | | | - Hoda A. Ibrahim
- Medical Biochemistry Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Asmaa Fawzy Eltantawy
- Medical Pharmacology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Fotouh Rashed Mansour
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Amina M. Salama
- Medical Parasitology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Pouryousef A, Hashemi SM, Omidian M, Mikaeili F, Sarkari B. Seroprevalence of Canine Toxocariasis in Three Rural Areas of Fars Province, Southern Iran. IRANIAN JOURNAL OF PARASITOLOGY 2024; 19:38-44. [PMID: 38654942 PMCID: PMC11033540 DOI: 10.18502/ijpa.v19i1.15191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/11/2024] [Indexed: 04/26/2024]
Abstract
Background Toxocara canis is one of the most important causes of animal toxocariasis with global distribution. We aimed to find out the seroprevalence of toxocariasis in dogs in a rural area in Fars Province, south of Iran. Methods Dogs blood samples were collected from 60 dogs in three rural areas in the Sar Mashhad region, Fars Province. Dog sera were evaluated for anti-Toxocara antibodies by an indirect ELISA method. The association between the seropositivity and age, gender, and the sampling location were statistically evaluated. Results Serological assay detected anti-Toxocara antibodies in sera of 32 out of 60 dogs, corresponding to a seroprevalence of 53.3%. The rate of seropositivity was higher in the male dogs. The rate of seropositivity was higher in old dogs. This rate increased with increasing age, however, the association between age and Toxocara seropositivity was not statistically significant. Conclusion The high prevalence of Toxocara infection in dogs in the current study area confirms that infected dogs are an important source of Toxocara infection for their owners and people who are in close contact with these animals, especially children.
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Affiliation(s)
- Ali Pouryousef
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyyed Mohammad Hashemi
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Omidian
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fattaneh Mikaeili
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - 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
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Khalifa MM, Fouad EA, Kamel NO, Auda HM, El-Bahy MM, Ramadan RM. Dogs as a source for the spreading of enteric parasites including zoonotic ones in Giza Province, Egypt. Res Vet Sci 2023; 161:122-131. [PMID: 37379694 DOI: 10.1016/j.rvsc.2023.06.015] [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: 03/13/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/30/2023]
Abstract
To investigate the impact of domestic and stray dogs on the transmission of zoonotic and other parasites to humans in contact with them, fecal samples were collected from 80 domestic dogs that presented at a clinic with health disturbances and 220 randomly selected stray dogs housed in shelters. The parasitological examination of these samples revealed infection by six zoonotic and four non-zoonotic parasites in varying percentages. The zoonotic parasites included Ancylostoma caninum, Toxocara canis, Dipylidium caninum, Echinococcus granulosus, Cryptosporidium species, and Giardia cysts and trophozoites. The other parasites included Toxascaris leonina, Trichuris vulpis, Taenia species eggs, and Isospora canis oocysts. The infection rate was higher in stray dogs (60%) than in domestic dogs (40%). Infected dogs in both groups were generally unhealthy, with poor body condition recorded in 13.8% of domestic dogs and 63.6% of stray dogs. The infection rate was higher (92%) among shelter workers than among domestic dog owners (66.7%). Giardia assemblages A and D from dogs and assemblage A from humans, as well as two isolates of Cryptosporidium canis (C. canis), one from dogs and the other from humans, were submitted in the GenBank with the accession numbers OQ870443, OQ870444, and OQ919265 for Giardia and OQ917532 & OQ915519 for C. canis of dogs & human, respectively. In conclusion, domestic and stray dogs play an essential role in transmitting zoonotic parasites to humans in contact with them, and regular deworming and strict hygienic measures are recommended to minimize their impact on human health.
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Affiliation(s)
- Marwa M Khalifa
- Department of Parasitology, Faculty of Veterinary Medicine, Cairo University, P.O. 12211, Giza, Egypt
| | - Ehab A Fouad
- Department of Zoonosis, Veterinary Research Institute, National Research Centre, Dokki, Giza, Egypt
| | - Nancy O Kamel
- Department of Parasitology, Faculty of Medicine, October 6 University, Egypt
| | - Hend M Auda
- Department of Medicine and Infectious Diseases, Faculty of Veterinary Medicine, Cairo University, P.O. 12211, Giza, Egypt
| | - Mohamed M El-Bahy
- Department of Parasitology, Faculty of Veterinary Medicine, Cairo University, P.O. 12211, Giza, Egypt
| | - Reem M Ramadan
- Department of Parasitology, Faculty of Veterinary Medicine, Cairo University, P.O. 12211, Giza, Egypt.
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Kruszon-Moran D, Brody D, Pearce B. Association of infection with Toxoplasma gondii and Toxocara on cognitive function among US adults aged 60 and over, NHANES 2011-2014. J Epidemiol Community Health 2023; 77:315-321. [PMID: 36849240 PMCID: PMC10127138 DOI: 10.1136/jech-2022-219772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/11/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Toxoplasma gondii and Toxocara are common parasites that infect humans globally. Our aim was to examine the relationship between T. gondii and Toxocara infection and cognition. METHODS Multivariate logistic regression was used to test the association of T. gondii and Toxocara seropositivity on indices of cognitive function (a word list learning trial with delayed recall from the Consortium to Establish a Registry for Alzheimer's Disease, an animal fluency test (AFT) and a digit symbol substitution test (DSST)) among 2643 adults aged 60 years and older in the 2011-2014 National Health and Nutrition Examination Survey. RESULTS Seropositivity to T. gondii or Toxocara were both associated with lower scores in all three cognitive function measures examined in univariate analyses. Except for the DSST, these associations were not significant after adjustment for age, gender, race and Hispanic origin, poverty level, education, US birth status, depression and hypertension. On stratification to account for significant interactions, Toxocara seropositivity was associated with worse scores on the AFT among those born outside the USA, worse scores on the DSST among those aged 60-69 years, female, Hispanic and with a high school diploma or less. Lower DSST scores with Toxocara infection was greater for adults living below compared with at or above the poverty level. CONCLUSIONS Seropositivity to these parasites, particularly to Toxocara, may be associated with diminished cognitive performance in certain subgroups of older adults.
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Affiliation(s)
- Deanna Kruszon-Moran
- National Center for Health Statistics, Division of Health and Nutrition Examination Surveys, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA
| | - Debra Brody
- National Center for Health Statistics, Division of Health and Nutrition Examination Surveys, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA
| | - Bradley Pearce
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
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Lee Y, Song YS, Phi JH, Kim IO, Kim K. A case report of spinal toxocariasis with extensive tumor-like involvement. Childs Nerv Syst 2023; 39:811-814. [PMID: 36319863 DOI: 10.1007/s00381-022-05674-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/10/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Toxocariasis is a common parasitic infection worldwide. Although it can present as several clinical syndromes, neurological manifestation is rare. Only a few reports are available on spinal cord involvement of toxocariasis. We report a case that presented with gait disturbance due to progressive lower limb spasticity. The patient had had visceral toxocariasis infection 8 years before. A spine magnetic resonance image (MRI) showed syringomyelia along the entire thoracic cord with small nodular enhancing lesions in the mid-portion of the syrinx, which led to the suspicion of ependymoma. Surgical mass removal was performed. However, histopathological examination of the mass did not show any malignant cells; instead, there were numerous axonal retraction balls with an eosinophilic granular body-like appearance. The serum antibody titer against toxocariasis was borderline high. Taken together, these observations led to a diagnosis of Toxocara infection, and the patient was treated with albendazole. CONCLUSION To the best of our knowledge, this is the first case report of tumor-like spinal toxocariasis involving extensive lesions. A solid enhancing mass with accompanied syrinx and hemorrhage might be a Toxocara infection. It can easily be diagnosed with serologic tests and simply be treated with oral albendazole if suspected.
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Affiliation(s)
- Yeji Lee
- Department of Rehabilitation Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Young Seop Song
- Seoul Gangnam Rehabilitation Clinic, 227 Seolleung-Ro, Gangnam-gu, Seoul, 06275, Republic of Korea
| | - Ji Hoon Phi
- Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - In-One Kim
- Department of Radiology, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Keewon Kim
- Department of Rehabilitation Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
- Seoul National University College of Medicine, 103 Daehak-Ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Abstract
Toxocara canis (from dogs) is recognised as a potential cause of human toxocarosis, but Toxocara cati (from cats) and other species (eg, Toxascaris leonina found in foxes) are also possible causes. Most colonisation with Toxocara species does not lead to symptomatic infection in well-cared for adult animals; young and debilitated animals are at greater risk. Humans can acquire infection from infected animals, for example, via soil contaminated with faeces; however, most human infections are asymptomatic, with symptomatic infection being very rare in the UK. The risk of human infection is reduced by measures such as hand washing and responsible disposal of dog faeces. Some organisations recommend regular prophylactic treatment of pet dogs and cats. However, there are concerns that some parasiticides are contaminating the environment. As an example of a One-Health problem there is a potential conflict between the needs of animal health, human health and the health of the wider ecosystem. Also, considering that only about 5% of non-juvenile household dogs shed Toxocara eggs at a given time, it has been questioned whether it is worthwhile to invest in frequent blind treatments. British veterinary organisations have suggested less frequent treatment may be more appropriate and should be based on individual risk assessment and faecal examinations for worms rather than blanket regular prophylactic treatment, which could reduce the impact of parasiticides on the environment without greatly increasing the risks to animal or human health.
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Walcher DL, de Sousa NFGC, Rocha LS, Mattos GT, Klafke GB, Scaini JLR, Berne MEA, Avila LFC, Scaini CJ. LARVICIDE ACTIVITY OF LACTOBACILLUS SPP. AND SACCHAROMYCES BOULARDII SUPERNATANTS ON TOXOCARA CANIS. J Parasitol 2023; 109:15-19. [PMID: 36805241 DOI: 10.1645/20-161] [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: 02/18/2023] Open
Abstract
Experimental studies have demonstrated the potential of probiotics to control visceral toxocariasis, which is a tissue parasitosis that is difficult to treat. This study evaluated the in vitro activity of probiotics and their supernatants on Toxocara canis larvae. The probiotics Lactobacillus rhamnosus (ATCC 7469), Lactobacillus paracasei (ATCC 335), Saccharomyces boulardii, Saccharomyces cerevisiae, and Bacillus cereus var. toyoi were tested in the following preparations: probiotic (P) 1 × 102 to 1 × 109 colony-forming units (CFUs), inactivated probiotic (IP) 1 × 102 to 1 × 109 CFUs, supernatant probiotic (SUpP), and inactivated probiotic supernatant (SupIP). The probiotics and their respective supernatants were separately incubated with 100 T. canis larvae per well using microculture plates with RPMI-1640 medium for 48 hr at 37 C and 5% CO2. The evaluation of the in vitro tests was based on the viability of T. canis larvae, through morphologic integrity, positive motility, and the absence of trypan blue stain. Only culture supernatants (SUpP and SUpIP) of Lactobacillus spp. resulted in 100% dead larvae, whereas S. boulardii showed larvicidal activity in T. canis >70%. The rest of the tests did not show larvicide activity. Therefore, it is important to investigate the supernatant effects of Lactobacillus spp. and S. boulardii in vivo on T. canis visceral infections, their mechanisms of action, and major metabolites involved.
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Affiliation(s)
- D L Walcher
- Post-Graduate Program in Parasitology, Department of Microbiology and Parasitology, Universidade Federal de Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil 96203900
| | - N F G C de Sousa
- Graduate Program in Medicine-School of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil 96203900
| | - L S Rocha
- Graduate Program in Medicine-School of Medicine, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil 96203900
| | - G T Mattos
- Post-Graduate Program in Health Sciences-Parasitology Laboratory, Universidade Federal do Rio Grande (FURG), Academic Area of the University Hospital-FURG, Rio Grande, Rio Grande do Sul, Brazil 96203900
| | - G B Klafke
- Parasitology Laboratory, Universidade Federal do Rio Grande (FURG), Academic Area of the University Hospital-FURG, Rio Grande, Rio Grande do Sul, Brazil 96203900
| | - J L R Scaini
- Post-Graduate Program in Health Sciences-Parasitology Laboratory, Universidade Federal do Rio Grande (FURG), Academic Area of the University Hospital-FURG, Rio Grande, Rio Grande do Sul, Brazil 96203900
| | - M E A Berne
- Post-Graduate Program in Parasitology, Department of Microbiology and Parasitology, Universidade Federal de Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil 96203900
| | - L F C Avila
- Post-Graduate Program in Health Sciences-Parasitology Laboratory, Universidade Federal do Rio Grande (FURG), Academic Area of the University Hospital-FURG, Rio Grande, Rio Grande do Sul, Brazil 96203900
| | - C J Scaini
- Post-Graduate Program in Health Sciences-Parasitology Laboratory, Universidade Federal do Rio Grande (FURG), Academic Area of the University Hospital-FURG, Rio Grande, Rio Grande do Sul, Brazil 96203900
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Pourgholaminejad A, Razipour H, Heydarian P, Ashrafi K, Roushan ZA, Sharifdini M. A survey on the seroprevalence of toxocariasis and related risk factors in Eosinophilic children of Northwest Iran. Afr Health Sci 2022; 22:617-625. [PMID: 36910401 PMCID: PMC9993322 DOI: 10.4314/ahs.v22i3.66] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Toxocariasis is a serious zoonotic helminthic disease caused by the nematodes; Toxocara species. Aim A cross-sectional study was conducted to determine the seroprevalence of toxocariasis and related risk factors in eosinophilic children referred to the pediatrics hospital of Qazvin province northwest Iran during 2019-2020. Methods A total of 200 blood samples were collected from eosinophilic children referred to the Qods Pediatrics Hospital. Demographic data, clinical symptoms, and dogs- and soil-contact history were collected. The presence of anti-Toxocara IgG antibody was evaluated by T. canis IgG ELISA kit. Results Anti-Toxocara IgG antibodies were detected in 14 (7%) of the total eosinophilic children. The seropositive rate of toxocariasis in hyper-eosinophilic children (>1000/mm3) was 15.1%, while the seropositivity was 4.1% in children with eosinophilia status (500-999/mm3). There was a significant association between the eosinophilia rate and seropositivity (P<0.05). Also, seroprevalence in asymptomatic eosinophilic children was 4.4%, while in children with clinical symptoms it was 17.1%. Accordingly, a statistically significant difference was found between clinical symptoms and Toxocara infection (P<0.05). Conclusion The prevalence of toxocariasis in eosinophilic children is a serious health problem in the study area. Therefore, serologic evaluation for the diagnosis of Toxocara infection is recommended for eosinophilic children.
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Affiliation(s)
- Arash Pourgholaminejad
- Department of Immunology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Habib Razipour
- Department of Medical Parasitology and Mycology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Peyman Heydarian
- Department of Medical Parasitology and Mycology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Keyhan Ashrafi
- Department of Medical Parasitology and Mycology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Atrkar Roushan
- Department of Biostatistics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Meysam Sharifdini
- Department of Medical Parasitology and Mycology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Ardekani A, Roshanshad A, Hosseini SA, Magnaval JF, Abdollahi A, Rostami A. Toxocariasis-associated urinary system diseases: a systematic review of reported cases. Trans R Soc Trop Med Hyg 2021; 116:668-672. [PMID: 34791477 DOI: 10.1093/trstmh/trab177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Toxocariasis is a neglected tropical disease caused by Toxocara canis and Toxocara cati. Toxocara species can involve many organs, such as the brain, heart and lungs, however, the urinary system involvement of toxocariasis is largely unknown. METHODS We performed a systematic review to identify cases infected with urinary tract toxocariasis. RESULTS We identified seven cases that were eligible to be reviewed. Among the included citations, four studies reported bladder involvement and three reported kidney involvement. Fever, urinary, and abdominal presentations were amongst the most important clinical symptoms. Eosinophilic cystitis and nephrotic syndrome were the most common diagnoses.. The treatment regimen included a combination of anthelmintic drugs and steroids. CONCLUSIONS In cases of urinary tract presentations accompanied by eosinophilia or histopathologic findings suggestive of parasitic infection, toxocariasis should be included in the list of differential diagnoses, especially in endemic areas.
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Affiliation(s)
- Ali Ardekani
- School of Medicine, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
| | - Amirhossein Roshanshad
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
| | - Seyed Ali Hosseini
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
| | - Jean-François Magnaval
- Department of Medical Parasitology, Faculty of Medicine, University of Toulouse, Toulouse 31000, France
| | - Ali Abdollahi
- Department of Surgery, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran 1949635881, Iran
| | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 4717647745, Iran
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Asadi N, Tappeh KH, Mohebbi I, Yousefi E, Khademvatan S. Screening of Cystic Echinococcosis and Toxocariasis in Urmia Municipal Workers, Northwest Iran. Infect Disord Drug Targets 2021; 21:220-229. [PMID: 32516106 DOI: 10.2174/1871526520666200609121400] [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: 12/23/2019] [Revised: 04/16/2020] [Accepted: 04/22/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Echinococcus granulosus and Toxocara spp., the causative agents of hydatid cyst and toxocariasis in humans and animals, are zoonotic infections with medical and veterinary significance respectively. AIM Herein, we aimed to investigate the seroprevalence of toxocariasis and cystic echinococcosis in Urmia municipal workers (gardeners and sweepers) in 2018 using ELISA assay. OBJECTIVE There is no precise report on the seroprevalence of toxocariasis and cystic echinococcosis in Urmia municipal workers using ELISA assay. Therefore, this study found an opportunity to investigate this subject. METHODS A total of 220 blood samples were obtained from municipal workers with an average age of 41.31 ± 9.42. Commercial anti-Toxocara canis and hydatid cyst ELISA kits were used to assess the seroprevalence rates. RESULTS Approximately, 14.5% and 2.3% of individuals were seropositive for toxocariasis and hydatidosis, respectively. Consuming unboiled milk and/or raw/uncooked meat and rural conditions are risk factors for toxocariasis. Regarding hydatidosis, consuming unwashed vegetables was the only statistically significant risk factor. Toxocara infection (p = 0.01), but not hydatid cyst (p = 0.05), is more prevalent among sweepers than municipal gardeners. CONCLUSION Due to the occupational condition of municipal workers, they are exposed to many infectious agents; thus, more researches should be done on these populations.
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Affiliation(s)
- Negar Asadi
- Cellular and Molecular Research Center & Department of Medical Parasitology and Mycology, Urmia University of Medical Sciences, Urmia, Iran
| | - Khosrow Hazrati Tappeh
- Cellular and Molecular Research Center & Department of Medical Parasitology and Mycology, Urmia University of Medical Sciences, Urmia, Iran
| | - Iraj Mohebbi
- Social Determinants of Health Center, Occupational Medicine Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Elham Yousefi
- Department of Medical Parasitology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahram Khademvatan
- Cellular and Molecular Research Center & Department of Medical Parasitology and Mycology, Urmia University of Medical Sciences, Urmia, Iran
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Waindok P, Kann S, Aristizabal A, Dib JC, Strube C. Toxocara Seroprevalence and Risk Factor Analysis in Four Communities of the Wiwa, an Indigenous Tribe in Colombia. Microorganisms 2021; 9:microorganisms9081768. [PMID: 34442846 PMCID: PMC8401469 DOI: 10.3390/microorganisms9081768] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 01/06/2023] Open
Abstract
The life of the indigenous Wiwa tribe in northeast Colombia is characterized by lacking access to clean drinking water and sanitary installations. Furthermore, free-roaming domestic animals and use of yucca and/or manioc as a primary food source favor the transmission of soil-transmitted helminths, e.g., Toxocara canis and Toxocara cati, the roundworms of dogs and cats. Infection may result in the clinical picture of toxocarosis, one of the most common zoonotic helminthoses worldwide. To estimate the Toxocara seroprevalence in four different villages of the Wiwa community, serum samples from 483 inhabitants were analyzed for anti-Toxocara-antibodies. Overall, 79.3% (383/483) of analyzed samples were seropositive. Statistically significant differences were observed between the four villages, as well as age groups (adults > adolescents > children), while sex had no effect. The high seropositivity rate demonstrates the risk of zoonotic roundworm infections and potential clinical disease in vulnerable indigenous inhabitants.
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Affiliation(s)
- Patrick Waindok
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, 30559 Hanover, Germany;
| | - Simone Kann
- Medical Mission Institute, 97074 Würzburg, Germany;
| | - Andrés Aristizabal
- Tropical Health Foundation, Santa Marta 470003, Colombia; (A.A.); (J.C.D.)
| | - Juan Carlos Dib
- Tropical Health Foundation, Santa Marta 470003, Colombia; (A.A.); (J.C.D.)
- Departement of Medicine, Universidad del Norte, Barranquilla 081001, Colombia
| | - Christina Strube
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, 30559 Hanover, Germany;
- Correspondence: ; Tel.: +49-511-9538711
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Sandra Guadalupe B, Mario Noé M, Gustavo Esteban P, Norma Yvett G, Karina C, Alma Leticia C, Alan Eduardo H, José Guadalupe H, Álvaro P, Alejandro Gabriel G, Martha P. Detection of antigens and anti-Toxocara canis antibodies in children with different asthma severities. Immun Inflamm Dis 2021; 9:435-442. [PMID: 33559301 PMCID: PMC8127555 DOI: 10.1002/iid3.403] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Toxocara canis can produce or exacerbate asthma, and the detection of anti-T. canis immunoglobulin G (IgG) does not discriminate between recent infection or active larva migrans. In this study, we searched for T. canis third-stage larval antigens (L3 TES) and anti-T. canis antibodies in children with different severities of asthma, controlled or uncontrolled. METHODS A total of 145 patients with asthma who were previously diagnosed using the Global Initiative for Asthma guidelines were included. The asthma control was evaluated with the Asthma Control Questionnaire (ACQ). Enzyme-linked immunosorbent assay was performed for the detection of L3 TES; IgG was detected using sera preadsorbed with Ascaris antigens (native kit), and a commercial kit (IgG) was used as the gold standard. RESULTS L3 TES was found in 2 patients (1.37%). One had L3 TES and anti-T. canis IgG, suggesting active larva migrans. In the other patient, only L3 TES was detected, likely because an infection had begun. The seroprevalence with the commercial kit and native kit was 6.2% and 17.93%, respectively. There was no significant association among asthma severity, ACQ and T. canis seroprevalence (p > .05). CONCLUSION It is possible to detect L3 TES in patients with asthma. Two complementary techniques that can determine the infection status with T. canis and rule out cross-reactions involve the detection of L3 TES and IgG using sera preadsorbed with Ascaris antigen. There was no significant association among asthma severity, ACQ and T. canis seroprevalence.
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Affiliation(s)
- Bautista‐García Sandra Guadalupe
- Servicio de Inmunología y Alergia, Departamento de Consulta Externa de PediatríaInstituto Nacional de Pediatría (INP)Ciudad de MéxicoMéxico
| | - Martínez‐Gordillo Mario Noé
- Laboratorio de Parasitología Experimental, Subdirección de Medicina ExperimentalInstituto Nacional de Pediatría (INP)Ciudad de MéxicoMéxico
| | - Peralta‐Abarca Gustavo Esteban
- Laboratorio de Parasitología Experimental, Subdirección de Medicina ExperimentalInstituto Nacional de Pediatría (INP)Ciudad de MéxicoMéxico
| | - González‐Bobadilla Norma Yvett
- Servicio de Inmunología y Alergia, Departamento de Consulta Externa de PediatríaInstituto Nacional de Pediatría (INP)Ciudad de MéxicoMéxico
| | - Clavijo‐Sánchez Karina
- Departamento de Biología, Facultad de CienciasUniversidad Nacional Autónoma de MéxicoCiudad de MéxicoMéxico
| | - Chávez‐Zea Alma Leticia
- Coordinación del Servicio Social, Facultad de MedicinaUniversidad Nacional Autónoma de MéxicoCiudad de MéxicoMéxico
| | | | - Huerta‐López José Guadalupe
- Servicio de Inmunología y Alergia, Departamento de Consulta Externa de PediatríaInstituto Nacional de Pediatría (INP)Ciudad de MéxicoMéxico
| | - Pedroza‐Meléndez Álvaro
- Servicio de Inmunología y Alergia, Departamento de Consulta Externa de PediatríaInstituto Nacional de Pediatría (INP)Ciudad de MéxicoMéxico
| | | | - Ponce‐Macotela Martha
- Laboratorio de Parasitología Experimental, Subdirección de Medicina ExperimentalInstituto Nacional de Pediatría (INP)Ciudad de MéxicoMéxico
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Toxocara canis and Toxocara cati Somatic and Excretory-Secretory Antigens Are Recognised by C-Type Lectin Receptors. Pathogens 2021; 10:pathogens10030321. [PMID: 33803269 PMCID: PMC8001263 DOI: 10.3390/pathogens10030321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 12/28/2022] Open
Abstract
Toxocara canis and Toxocara cati, the worldwide occurring intestinal roundworms of canids and felids, represent an important public health threat due to various disease manifestations in humans. Host recognition of pathogens is mediated by pattern recognition receptors (PRRs). Myeloid C-type lectin receptors (CLRs) are PRRs and recognise carbohydrate structures of various pathogens. As Toxocara excretory-secretory products (TES) are predominantly composed of glycoconjugates, they represent suitable targets for CLRs. However, the range of host-derived CLRs recognising Toxocara spp. is still unknown. Using a CLR-hFc fusion protein library, T. canis and T. cati L3 somatic antigens (TSOM) were bound by a variety of CLRs in enzyme-linked immunosorbent assay (ELISA), while their TES products interacted with macrophage galactose-type lectin-1 (MGL-1). Two prominent candidate CLRs, MGL-1 and macrophage C-type lectin (MCL), were selected for further binding studies. Immunofluorescence microscopy revealed binding of MGL-1 to the oral aperture of L3. Immunoblot experiments identified distinct protein fractions representing potential ligands for MGL-1 and MCL. To evaluate how these interactions influence the host immune response, bone marrow-derived dendritic cell (BMDC) assays were performed, showing MCL-dependent T. cati-mediated cytokine production. In conclusion, MGL-1 and MCL are promising candidates for immune modulation during Toxocara infection, deserving further investigation in the future.
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Hillyer JF. Parasites and Parasitology in this SARS-CoV-2, COVID-19 World: An American Society of Parasitologists Presidential Address. J Parasitol 2021; 106:859-868. [PMID: 33450760 DOI: 10.1645/20-158] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The novel coronavirus disease 2019 (COVID-19) is one of the worst global health crises of this generation. The core of this pandemic is the rapid transmissibility of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, its high morbidity and mortality, and the presence of infectious asymptomatic carriers. As a result, COVID-19 has dominated this year's headlines and commanded significant research attention. As we consider SARS-CoV-2 and the COVID-19 pandemic, it is essential that scientists, governments, the media, and the general population also come to grips with the everyday cost of parasitic diseases. Plasmodium (malaria), schistosomes, filarial worms, hookworms, Ascaris, whipworms, and other protozoan and metazoan parasites take a tremendous toll on local communities. Yet, because most of these diseases are no longer endemic to developed countries, their research and intervention are not funded at levels that are proportional to their global morbidity and mortality. The scientific and public health communities must indeed vigorously fight SARS-CoV-2 and COVID-19, but while doing so and beyond, it will be essential to demonstrate steadfast resolve toward understanding and combating the parasitic diseases that for centuries have haunted humankind.
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Affiliation(s)
- Julián F Hillyer
- Department of Biological Sciences, Vanderbilt University, Nashville, Tennessee 37235
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15
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A new ELISA and western blot technique based on recombinant TES antigen and/or larval antigen for the detection of toxocariasis in humans. Parasitology 2020; 148:333-340. [PMID: 33092663 PMCID: PMC7890350 DOI: 10.1017/s0031182020002085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Serological antibody detection by enzyme-linked immunosorbent assay (ELISA)- and immunoblot-based methods constitutes the best indicator of human Toxocara infection. Nevertheless, the availability of serological tests, particularly western blots (WB), evaluated for sensitivity and specificity is limited. Therefore, an Anti-Toxocara-ELISA immunoglobulin g (IgG) prototype (Proto-ELISA) and an Anti-Toxocara-Westernblot (IgG) prototype (Proto-WB) were evaluated by testing 541 human sera pre-determined for Toxocara infection by an established in-house Anti-Toxocara-ELISA (IH-ELISA). To evaluate sensitivity and specificity of the newly developed ELISA and WB prototypes, results were compared to IH-ELISA and a commercial WB (Com-WB). Compared to the IH-ELISA, a sensitivity of 93.1% (229/246) and a specificity of 94.6% (279/295) of the Proto-ELISA with a Cohen's κ of 0.88 were obtained. The sensitivity of the Proto-WB was 76.7% (240/313) and specificity was 99.6% (227/228) with a Cohen's κ of 0.73 compared to those of Com-WB. A comparison to the IH-ELISA revealed 91.5% (225/246) sensitivity and 94.6% (279/295) specificity of the Proto-WB with a Cohen's κ of 0.86. Cross-reactivity was observed for some samples positive for Ascaris and Trichinella spp. in the Proto-ELISA, Proto-WB and Com-WB. Overall, the evaluated ELISA and WB prototypes showed high sensitivity and specificity, indicating high reliability of these newly developed tests.
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16
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Soil Contamination with Toxocara Eggs in Public Schools in Rural Areas of Southern Thailand. J Trop Med 2020; 2020:9659640. [PMID: 32963555 PMCID: PMC7495207 DOI: 10.1155/2020/9659640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/17/2020] [Accepted: 08/26/2020] [Indexed: 11/17/2022] Open
Abstract
Soil is considered the primary source of Toxocara transmission to humans, especially children. The status of soil contamination with Toxocara eggs in southern Thailand is unknown. This study aimed at estimating the soil contamination with Toxocara eggs in public schools in Nakhon Si Thammarat province in southern Thailand. Soil samples were collected from 12 public schools between August and September 2017. At each site, ten soil samples were collected from the following five types of locations: (1) playgrounds, (2) football fields, (3) sidewalks, (4) schoolyards, and (5) areas around cafeterias. In total, 120 samples were examined for Toxocara eggs with a modified flotation method using a sucrose solution. Toxocara eggs were detected in 8 (66.7%) of the 12 studied public schools. Of the 120 soil samples, 22 (18.3%; 95% CI: 11.9, 26.4) were contaminated with Toxocara eggs. The highest levels of Toxocara egg contamination were observed in playgrounds (41.7%; 95% CI: 22.1, 63.4), followed by football fields (20.8%; 95% CI: 7.1, 42.2), sidewalks (12.5%; 95% CI: 2.7, 32.4), and schoolyards (12.5%; 95% CI: 2.7, 32.4). There were significant differences in the distribution of Toxocara eggs across location types (p < 0.05). The findings demonstrated that the soil samples from public schools were contaminated with Toxocara eggs. Playgrounds were the most heavily contaminated locations. Teaching children proper handwashing steps and discouraging geophagia should be implemented to reduce the distribution of Toxocara and limit future Toxocara infections.
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17
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Hanh NTL, Lee YL, Lin CL, Chou CM, Cheng PC, Quang HH, Fan CK. Evidence for Asthma in the Lungs of Mice Inoculated with Different Doses of Toxocara canis. Am J Trop Med Hyg 2020; 103:2305-2314. [PMID: 32975177 DOI: 10.4269/ajtmh.20-0484] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Toxocara canis, a common roundworm that mainly causes toxocariasis, is a zoonotic parasite found worldwide. Humans, an accidental host, can acquire T. canis infection through accidental ingestion of T. canis-embryonated egg-contaminated food, water, and soil, and by encapsulated larvae in a paratenic host's viscera or meat. Long-term residence of T. canis larvae in a paratenic host's lungs may induce pulmonary inflammation that contributes to lung injury, airway inflammatory hyperresponsiveness, and collagen deposition in mice and clinical patients. This study intended to investigate the relationship between T. canis infection and allergic asthma in BALB/c mice inoculated with high, moderate, and low doses of T. canis eggs for a 13-week investigation. The airway hyperresponsiveness (AHR) to methacholine, collagen deposition, cytokine levels, and pathological changes in lung tissues was assessed in infected mice at weeks 1, 5, and 13 postinfection. The cell composition in bronchoalveolar lavage fluid of infected mice was assessed at weeks 5 and 13 postinfection. Compared with uninfected control mice, all groups of T. canis-infected mice exhibited significant AHR, a dose-dependent increase in eosinophilic infiltration leading to multifocal interstitial and alveolar inflammation with abundant mucus secretion, and collagen deposition in which the lesion size increased with the infective dose. Infected mice groups also showed significant expressions of eotaxin and type 2 T-helper-dominant cytokines such as interleukin (IL)-4, IL-5, and IL-13. Overall, these results suggest that T. canis larval invasion of the lungs may potentially cause pulmonary inflammatory injury and could subsequently contribute to the development of allergic manifestations such as asthma.
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Affiliation(s)
- Nguyen Thi Lien Hanh
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Institute of Malariology, Parasitology and Entomology, Quy Nhon, Ministry of Health, Vietnam.,Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yueh-Lun Lee
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chu-Lun Lin
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chia-Mei Chou
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Po-Ching Cheng
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Huynh Hong Quang
- Institute of Malariology, Parasitology and Entomology, Quy Nhon, Ministry of Health, Vietnam
| | - Chia-Kwung Fan
- International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Cell Physiology and Molecular Image Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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18
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A Systematic Review and Meta-analysis of Toxocariasis in Iran: Is it Time to Take it Seriously? Acta Parasitol 2020; 65:569-584. [PMID: 32319035 DOI: 10.2478/s11686-020-00195-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 03/11/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Toxocariasis is one of the neglected zoonosis with considerable public health importance around the world. The current study aimed to elucidate the overall prevalence of Toxocara infection in human and definitive hosts and also the contamination of soil and raw vegetables with the ova of these parasites, in Iran, using systematic review and meta-analysis. METHODS Six English and Persian databases were explored from 2000 to 2017 using the terms toxocariasis, Toxocara spp., visceral larva migrans, Iran, epidemiology, and prevalence. This meta-analysis conducted using STATA, and for all statistical tests, a p value less than 0.05 was considered significant. The random-effects model was used to the report of the pooled prevalence with a 95% confidence interval (CI). RESULTS The pooled prevalence of toxocariasis in human was calculated as 11% (95% CI 8-13%). In terms of definitive hosts, the pooled prevalence of Toxocara infection in dogs and cats were calculated as 17% (95% CI 14-20%) and 37% (95% CI 26-48%), respectively. Also, the pooled prevalence of Toxocara spp. eggs in the soil and raw vegetable samples were calculated as 18% (95% CI 13-23%) and 2% (95% CI 1-3%), respectively. CONCLUSIONS The results of current study demonstrate that toxocariasis should be taken more seriously by health authorities. Implementing an appropriate control program is necessary to reduce the incidence of this disease in Iran.
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Comparison of the Level of Awareness about the Transmission of Echinococcosis and Toxocariasis between Pet Owners and Non-Pet Owners in Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155292. [PMID: 32708026 PMCID: PMC7432043 DOI: 10.3390/ijerph17155292] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/17/2020] [Accepted: 07/19/2020] [Indexed: 12/12/2022]
Abstract
Ζoonotic parasitic diseases that can occur through animal contact pose risks to pets, their owners and to their bond. This study aims to assess the level of knowledge about zoonoses, specifically echinococcosis and toxocariasis, among cat/dog owners and non-pet owners in Greece. Multiple-choice questionnaires were designed to obtain data regarding the knowledge of pet and non-pet owners on echinococcosis and toxocariasis, including signs and symptoms of these zoonoses, ways of transmission and precautions that need to be taken into account in order to avoid it. A total of 185 questionnaires were retrieved and data was expressed as absolute (Ν) and relative frequencies (%). Associations between pet ownership, residence and outcome variables were evaluated using the Fisher exact test and Chi-squared test, respectively. Multifactorial linear regression analysis was used to investigate the cross-sectional association between demographic characteristics and the awareness of helminthic zoonoses. All tests were two-sided and statistical significance was set at p < 0.05. Our study revealed a disturbing lack of awareness of echinococcosis and toxocariasis (mean zoonotic knowledge score 8.11 ± 3.18) independently of pet ownership. Surprisingly, in some cases the ignorance of pet owners exceeded that of non-pet owners. Given the progressive impact of toxocariasis in public health and the high prevalence of echinococcosis in the Mediterranean region, measures should be taken to inform people about zoonoses and eliminate their putative transmission.
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20
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Morales-Yánez F, Trashin S, Sariego I, Roucher C, Paredis L, Chico M, De Wael K, Muyldermans S, Cooper P, Polman K. Electrochemical detection of Toxocara canis excretory-secretory antigens in children from rural communities in Esmeraldas Province, Ecuador: association between active infection and high eosinophilia. Parasit Vectors 2020; 13:245. [PMID: 32398157 PMCID: PMC7216625 DOI: 10.1186/s13071-020-04113-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 04/29/2020] [Indexed: 01/08/2023] Open
Abstract
Background The diagnosis of active Toxocara canis infections in humans is challenging. Larval stages of T. canis do not replicate in human tissues and disease may result from infection with a single T. canis larva. Recently, we developed a nanobody-based electrochemical magnetosensor assay with superior sensitivity to detect T. canis excretory-secretory (TES) antigens. Here, we evaluate the performance of the assay in children from an Ecuadorian birth cohort that followed children to five years of age. Methods Samples were selected based on the presence of peripheral blood eosinophilia and relative eosinophil counts. The samples were analyzed by the nanobody-based electrochemical magnetosensor assay, which utilizes a bivalent biotinylated nanobody as capturing agent on the surface of streptavidin pre-coated paramagnetic beads. Detection was performed by a different nanobody chemically labelled with horseradish peroxidase. Results Of 87 samples tested, 33 (38%) scored positive for TES antigen recognition by the electrochemical magnetosensor assay. The average concentration of TES antigen in serum was 2.1 ng/ml (SD = 1.1). The positive result in the electrochemical assay was associated with eosinophilia > 19% (P = 0.001). Parasitological data were available for 57 samples. There was no significant association between positivity by the electrochemical assay and the presence of other soil-transmitted helminth infections. Conclusions Our nanobody-based electrochemical assay provides highly sensitive quantification of TES antigens in serum and has potential as a valuable tool for the diagnosis of active human toxocariasis.![]()
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Affiliation(s)
- Francisco Morales-Yánez
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium. .,Department of Biomedical Sciences, Unit of Medical Helminthology, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Stanislav Trashin
- AXES Research Group, Department of Chemistry, University of Antwerp, Antwerp, Belgium
| | - Idalia Sariego
- Institute of Tropical Medicine "Pedro Kourí", Havana, Cuba
| | - Clémentine Roucher
- Department of Biomedical Sciences, Unit of Medical Helminthology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Linda Paredis
- Department of Biomedical Sciences, Unit of Medical Helminthology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Martha Chico
- Fundación Ecuatoriana Para Investigación en Salud, Quito, Ecuador
| | - Karolien De Wael
- AXES Research Group, Department of Chemistry, University of Antwerp, Antwerp, Belgium
| | - Serge Muyldermans
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Philip Cooper
- Fundación Ecuatoriana Para Investigación en Salud, Quito, Ecuador.,Facultad de Ciencias Médicas, de la Salud y la Vida, Universidad Internacional del Ecuador, Quito, Ecuador.,Institute of Infection and Immunity, St George's University of London, London, UK
| | - Katja Polman
- Department of Biomedical Sciences, Unit of Medical Helminthology, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Health Sciences, Section Infectious Diseases, VU University Amsterdam, Amsterdam, The Netherlands
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21
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Fecková M, Antolová D, Zaleśny G, Halánová M, Štrkolcová G, Goldová M, Weissová T, Lukáč B, Nováková M. Seroepidemiology of human toxocariasis in selected population groups in Slovakia: A cross-sectional study. J Infect Public Health 2020; 13:1107-1111. [PMID: 32404252 DOI: 10.1016/j.jiph.2020.04.006] [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: 01/10/2020] [Revised: 04/03/2020] [Accepted: 04/12/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Human toxocariasis is a cosmopolitan helminthic zoonosis caused by roundworms of the genus Toxocara. The study aimed at a cross-sectional analysis of seropositivity to Toxocara spp. in selected groups of population in Slovakia and an estimate of the risk factors of infection. METHODS For the detection of anti-Toxocara antibodies, an enzyme-linked immunosorbent assay (ELISA) based on an excretory-secretory (E/S) antigen of Toxocara canis was used. RESULTS The overall seropositivity to Toxocara in 1489 evaluated sera was 3.7%. The seropositivity of Roma children/young people (40.3%) was significantly higher when compared with all other analysed groups. Among adult respondents, the positivity of farmers and hunters (5.5% and 5.1%, respectively) was significantly higher (p<0.001) than in the other analysed groups (veterinarians and veterinary assistants, soldiers, students of veterinary medicine, and students of other universities). Analysis of infection risk factors showed that living in a rural locality, everyday contact with soil, and everyday outdoor activities (12.7%, 8.8% and 8.3% positivity, respectively) can increase the risk of infection, but the observed differences were not significant. CONCLUSION The results underline the importance of preventive measures and the need for improving of knowledge of toxocariasis among professionals, as well as the public.
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Affiliation(s)
- Miroslava Fecková
- Institute of Parasitology of Slovak Academy of Sciences, Hlinkova 3, 040 01 Košice, Slovakia; University of Veterinary Medicine and Pharmacy in Košice, Komenského 73, 041 81 Košice, Slovakia
| | - Daniela Antolová
- Institute of Parasitology of Slovak Academy of Sciences, Hlinkova 3, 040 01 Košice, Slovakia.
| | - Grzegorz Zaleśny
- Department of Invertebrate Systematics and Ecology, Wroclaw University of Environmental and Life Sciences, C. K. Norwida 25, 50-375 Wrocław, Poland
| | - Monika Halánová
- P. J. Šafárik University in Košice, Trieda SNP 1, 040 11 Košice, Slovakia
| | - Gabriela Štrkolcová
- University of Veterinary Medicine and Pharmacy in Košice, Komenského 73, 041 81 Košice, Slovakia
| | - Mária Goldová
- University of Veterinary Medicine and Pharmacy in Košice, Komenského 73, 041 81 Košice, Slovakia
| | - Tatiana Weissová
- University of Veterinary Medicine and Pharmacy in Košice, Komenského 73, 041 81 Košice, Slovakia
| | - Branislav Lukáč
- University of Veterinary Medicine and Pharmacy in Košice, Komenského 73, 041 81 Košice, Slovakia
| | - Mária Nováková
- Catholic University in Ružomberok, Námestie A. Hlinku 48, 034 01 Ružomberok, Slovakia
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Chou CM, Fan CK. Seroprevalence of Toxocara spp. infection in Southeast Asia and Taiwan. ADVANCES IN PARASITOLOGY 2020; 109:449-463. [PMID: 32381212 DOI: 10.1016/bs.apar.2020.01.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Human toxocariasis is a worldwide neglected zoonotic parasitic disease and caused mainly by Toxocara canis, and to a lesser event, by T. cati. There are only 16 epidemiological studies and 5 clinical toxocariasis case reports in 11 Southeast Asia countries and Taiwan (SEAT) that were found by searching data from PubMed in the period from January 1992 to August 2019. The overall seroprevalence in SEAT varied from 3.9% to 84.6% chiefly detected by using T. canis larval excretory-secretory antigen (TcES)-based ELISA. Playing with dogs or contacting Toxocara eggs from the contaminated soil or vegetables or eating raw meats/viscera containing encapsulated larvae seem likely the major risk factors leading to human toxocariasis in SEAT. Nevertheless, undertaking comprehensive seroepidemiological studies to establish the baseline data and beware of clinical toxocariasis cases by physicians as well as establishing adequate serodiagnostic methods in detection of Toxocara infection, e.g., TcES-based immunoblotting method in helminth endemic SEA are strongly required.
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Affiliation(s)
- Chia-Mei Chou
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chia-Kwung Fan
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Research Center of International Tropical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Tropical Medicine Division, International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Toxocara species environmental contamination of public spaces in New York City. PLoS Negl Trop Dis 2020; 14:e0008249. [PMID: 32369482 PMCID: PMC7228133 DOI: 10.1371/journal.pntd.0008249] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 05/15/2020] [Accepted: 03/24/2020] [Indexed: 12/23/2022] Open
Abstract
Human toxocariasis has been identified as an under-diagnosed parasitic zoonosis and health disparity of significant public health importance in the United States due to its high seropositivity among socioeconomically disadvantaged groups, and possible links to cognitive and developmental delays. Through microscopy and quantitative PCR, we detected that Toxocara eggs are widespread in New York City public spaces, with evidence of significant levels of contamination in all five boroughs. The Bronx had the highest contamination rate (66.7%), while Manhattan had the lowest contamination rate (29.6%). Moreover, infective eggs were only found in the Bronx playgrounds, with over 70% of eggs recovered in embryonic form and the highest egg burden (p = 0.0365). All other boroughs had eggs in the pre-infectious, unembronyated form. Toxocara cati, the cat roundworm, was the predominant species. These results suggest that feral or untreated cats in New York City represent a significant source of environmental contamination. These findings indicate that human toxocariasis has emerged as an important health disparity in New York City, with ongoing risk of acquiring Toxocara infection in public spaces, especially in poorer neighborhoods. There is a need for reducing environmental Toxocara contamination. Additional rigorous public health interventions should explore further approaches to interrupt transmission to humans. Toxocara canis and Toxocara cati are helminth worms that infect dogs and cats, respectively. Infected dogs and cats will defecate thousands of Toxocara eggs into the environment. Humans are incidental hosts and are exposed when consuming contaminated soils via the fecal-oral route. After leaving the gastrointestinal tract, the Toxocara larvae will enter the vasculature and can migrate to any major organ system, including lungs, ocular, and central nervous system. Symptoms can range from mild muscle aches to severe asthma, blindness, and encephalitis. Humans are not definitive hosts of the parasite and cannot transmit Toxocara eggs to the environment or other humans. There is a need for research on the sanitary impact of Toxocara for both humans and animals, especially in large urban cities such as New York City. Poverty is also associated with higher rates of toxocariasis, with more contamination in poorer neighborhoods where animal control, deworming of pets, and less sanitary conditions exist. This study aims to understand further the disparity of lower socioeconomic areas having higher rates of contaminated parks and playgrounds, comparing the five boroughs of New York City.
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Abstract
Several imaging modalities have now been employed to visualize the manifestations of larval Toxocara infection in hepatic, neurologic, ocular, renal, and other anatomical sites. This report reviews the usefulness and value of these individual imaging methods in diagnosis and follow-up of the different cases causing eosinophilic (granulomatous) infiltrations the liver, lungs, brain, heart, and eyes. Imaging provides a means of assisting in diagnosis and management in this infection where diagnosis by biopsy is often unlikely to capture an actual larva for the purpose of making a definitive diagnosis on the basis of larval morphology or DNA detection.
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Affiliation(s)
- Christoph F Dietrich
- Department of Internal Medicine (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland.
| | - Carmen Cretu
- Department of Parasitology, Carol Davila University of Medicine and Pharmacy, Colentina Clinical Hospital, Bucharest, Romania
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
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Aghamolaie S, Seyyedtabaei SJ, Behniafar H, Foroutan M, Saber V, Hanifehpur H, Mehravar S, Rostami A. Seroepidemiology, modifiable risk factors and clinical symptoms of Toxocara spp. infection in northern Iran. Trans R Soc Trop Med Hyg 2020; 113:116-122. [PMID: 30407595 DOI: 10.1093/trstmh/try118] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 10/01/2018] [Accepted: 10/25/2018] [Indexed: 12/13/2022] Open
Abstract
Toxocariasis is one of the most important and widespread neglected tropical infectious diseases. We designed a cross-sectional study to assess the seroepidemiological aspects of toxocariasis among the general population in northern Iran. A total of 630 rural subjects were enrolled to participate in the study. The presence of anti-Toxocara immunoglobulin G (IgG) was tested using a commercially available enzyme-linked immunosorbent assay. A structured questionnaire was also used to evaluate the potential risk factors and related clinical signs/symptoms. The presence of anti-Toxocara IgG antibodies was detected in 148 of the 630 rural subjects (23.5% [95% confidence interval {CI} 21.8 to 25.1]). By multivariate analysis, age (odds ratio [OR] 2.89 [95% CI 1 to -8.3], p=0.04), eating improperly washed vegetables (OR 4.05 [95% CI 2.47 to 6.64], p<0.001), contact with dogs (OR 3.31 [95% CI 2.13 to 5.12], p<0.001) and exposure to soil (OR 3.56 [95% CI 2.13 to 5.13], p<0.001) were significantly associated with the seroprevalence of Toxocara. The clinical study also demonstrated that the seroprevalence of Toxocara infection was significantly associated with asthma (OR 3.78 [95% CI 1.63 to 8.75], p<0.001) and ophthalmic disorder (OR 1.83 [95% CI 1.04 to 3.21], p=0.034). The findings proved that residents of rural communities in tropical regions may be heavily exposed to Toxocara spp. We highly recommend more investigations in high-risk groups.
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Affiliation(s)
- Somayeh Aghamolaie
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyyed Javad Seyyedtabaei
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Behniafar
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Foroutan
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Vafa Saber
- Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hooman Hanifehpur
- Department of Biological Control and Vaccine, Food and Drug Administration, Tehran, Iran
| | - Saeed Mehravar
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Science, Tehran, 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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Bradbury RS, Hobbs CV. Toxocara seroprevalence in the USA and its impact for individuals and society. ADVANCES IN PARASITOLOGY 2020; 109:317-339. [PMID: 32381205 DOI: 10.1016/bs.apar.2020.01.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Toxocara species are intestinal helminths of dogs and cats, the larval stages of which may infect humans and cause severe neural, ocular and visceral larva migrans disease. Such cases of severe overt disease represent only a small fraction of the of the US population who have been exposed and infected with Toxocara, subsequently developing IgG antibodies to the larvae. The true impact of exposure to Toxocara in this large group of Americans remains uncertain. Toxocara antibody positivity is associated with poverty, but other specific risk factors have been identified, including sex, age, rural residence, region of residence, race and exposure to pets. This seropositive status has also been associated with several childhood diseases, including asthma and epilepsy, increased serum lead levels, and poor neurocognitive function. Three large-scale NHANES studies have provided comprehensive datasets, while several smaller studies have explored specific disease associations. Each seroprevalence study must be interpreted in consideration of the sensitivity and specificity of the individual serological methods employed. This chapter summarizes all historical Toxocara prevalence data from dogs, cats and soil in the United States. It then carefully examines all previous human Toxocara seroprevalence surveys performed in the United States. Data from these surveys is assimilated, compared and discussed to determine the validity of findings and to accurately identify risk factors for Toxocara seropositivity. The validity of associations of exposure to Toxocara larvae and childhood diseases such as asthma and epilepsy and effects neurocognitive function within the American context are also explored.
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Affiliation(s)
- Richard S Bradbury
- School of Health and Life Sciences, Federation University Australia, Berwick, VIC, Australia.
| | - Charlotte V Hobbs
- Children's of Mississippi, University of Mississippi Medical Center, Jackson, MS, United States
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Ketzis JK, Lucio-Forster A. Toxocara canis and Toxocara cati in domestic dogs and cats in the United States, Mexico, Central America and the Caribbean: A review. ADVANCES IN PARASITOLOGY 2020; 109:655-714. [PMID: 32381223 DOI: 10.1016/bs.apar.2020.01.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Toxocara prevalence ranges from 0 to >87% and 0 to >60% in dogs and cats, respectively, within the United States, Mexico, Central America and the Caribbean. Higher prevalence occurs in animals less than 1 year of age. Overall, prevalence is higher in cats compared to dogs. The lowest prevalence occurs in the US owned dog population. Specific populations in this industrialized nation, in animal shelters or resource-limited locations, have prevalences similar to those seen in populations from other regions reviewed here. Conversely, subpopulations in Central America and the Caribbean have very low prevalence. Apparent contributors to prevalence, excluding animal age and climate, are socio-economic factors, attitudes towards pet management and animal population density. The lack of data from some regions pose a challenge in assessing trends; however, with the exception of the US owned dog population, there is no strong indication of any decrease in prevalence from historical levels.
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Affiliation(s)
- Jennifer K Ketzis
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts and Nevis, West Indies.
| | - Araceli Lucio-Forster
- Department of Microbiology and Immunology, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
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Seroprevalence of human toxocarosis in Europe: A review and meta-analysis. ADVANCES IN PARASITOLOGY 2020; 109:375-418. [PMID: 32381208 DOI: 10.1016/bs.apar.2020.01.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Toxocarosis is distributed worldwide and represents the most prevalent zoonotic helminth infection in industrialized countries, thereby posing a substantial risk for public health. Thus, toxocarosis is one of CDC's Neglected Parasitic Infections that has been targeted for public health action. This systematic review and meta-analysis summarizes Toxocara seroprevalence in general populations from Europe, populations suspected of Toxocara infection and defined risk groups. Random-effects meta-analysis of proportions based on 41 publications resulted in an overall seroprevalence of 6.2% (95% CI: 4.7-8.3%) in the general population of Europe. Subgroup analysis according to decades (1970-2010s) revealed a significant increase in seroprevalence, with the highest value (12.4%; 95% CI: 6.5-22.3%) in the 2010s (χ2=17.87, df=4, P=0.001). There were no significant differences between pooled prevalence rates of European sub-regions (χ2=3.01, df=3, P=0.389). Furthermore, meta-analysis of seroprevalence according to age groups, based on data from 22 publications, indicated a significantly higher pooled seroprevalence of 14.9% (95% CI: 8.5-24.8%) in people more than 50 years of age than in younger age cohorts (χ2=8.33, df=2, P=0.016). Occupational groups exposed to contaminated soil and infected animals bear substantial risk for acquiring Toxocara infection. Due to the close link between animal infection and human Toxocara exposure, a "One Health" approach for the prevention of Toxocara infection in both humans and animals is required.
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Inagaki K, Kirmse B, Bradbury RS, Moorthy RS, Arguello I, McGuffey CD, Tieu B, Hobbs CV. Case Report: Ocular Toxocariasis: A Report of Three Cases from the Mississippi Delta. Am J Trop Med Hyg 2020; 100:1223-1226. [PMID: 30860012 DOI: 10.4269/ajtmh.18-0766] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Ocular toxocariasis can be vision threatening, and is commonly reported from tropical or subtropical regions. Knowledge of clinical manifestations from the United States, particularly in underserved areas such as the American South, is lacking. We report three cases of ocular toxocariasis in individuals from the Mississippi Delta, a rural community with prevalent poverty. Visual acuity was severely affected in two of the three cases. Increased awareness of ocular toxocariasis, which may have under-recognized frequency, will contribute to prompt diagnosis and treatment, which will ultimately improve patient health in the region.
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Affiliation(s)
- Kengo Inagaki
- Division of Infectious Diseases, Children's Hospital, University of Mississippi Medical Center, Jackson, Mississippi
| | - Brian Kirmse
- Division of Genetics, University of Mississippi Medical Center, Jackson, Mississippi
| | - Richard S Bradbury
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ramana S Moorthy
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Irene Arguello
- Division of Infectious Diseases, Children's Hospital, University of Mississippi Medical Center, Jackson, Mississippi
| | - Charles D McGuffey
- Department of Transitional Medicine, Methodist University Hospital, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Brian Tieu
- Department of Ophthalmology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Charlotte V Hobbs
- Division of Infectious Diseases, Children's Hospital, University of Mississippi Medical Center, Jackson, Mississippi
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Prevalence of Toxocara and Toxascaris infection among human and animals in Iran with meta-analysis approach. BMC Infect Dis 2020; 20:20. [PMID: 31910815 PMCID: PMC6947998 DOI: 10.1186/s12879-020-4759-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 12/31/2019] [Indexed: 12/29/2022] Open
Abstract
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.
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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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Shirvani G, Abdizadeh R, Manouchehri Naeini K, Mortezaei S, Khaksar M. The Study of Soil Contamination by Toxocara spp. Eggs in Different Areas of Chaharmahal and Bakhtiari Province, Southwest Iran. INTERNATIONAL JOURNAL OF EPIDEMIOLOGIC RESEARCH 2019. [DOI: 10.15171/ijer.2019.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background and aims: Toxocariasis caused by the larvae of Toxocara spp. is a zoonotic infection with global distribution that is considered an important health problem in the humans. The soil is regarded as the main source of the transmission of Toxocara infection to susceptible hosts. This study investigated the existence of Toxocara spp. ova in rural and urban public areas of Chaharmahal and Bakhtiari province. Methods: A total of 180 soil samples were randomly collected from 74 public places from urban and rural areas of nine counties of Chaharmahal and Bakhtiari province during May to September, 2017. The samples were examined for Toxocara spp. eggs by the modified sucrose flotation method. Results: The contamination rate of the soil samples with Toxocara spp. ova varied within 0%-18.1% in different counties. Overall, 9 (5%) out of 180 examined soil samples were found positive for Toxocara spp. ova. Of nine investigated districts, Toxocara spp. ova were observed in four counties and the highest rate of soil contamination was found in Farsan county with 18.1%. Finally, the prevalence of Toxocara spp. eggs was more in the rural areas (6.7%) compared to the urban ones (3.3%). Conclusion: This study was the first investigation regarding the contamination of Toxocara spp. eggs in the soil of public places in rural and urban areas of Chaharmahal and Bakhtiari province. According to the results, the rate of soil contamination in this region was lower compared with the other parts of Iran. Therefore, a further study is required to determine factors that may be involved in the distribution of Toxocara spp. in different areas of this province.
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Affiliation(s)
- Giti Shirvani
- Medical Parasitology, Seyed-al-Shohada Hospital of Farsan, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Rahman Abdizadeh
- Department of Medical Parasitology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Koroush Manouchehri Naeini
- Department of Medical Parasitology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Seifollah Mortezaei
- Medical Parasitology, Seyed-al-Shohada Hospital of Farsan, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mina Khaksar
- Department of Medical Parasitology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Creevy KE, Grady J, Little SE, Moore GE, Strickler BG, Thompson S, Webb JA. 2019 AAHA Canine Life Stage Guidelines*. J Am Anim Hosp Assoc 2019; 55:267-290. [DOI: 10.5326/jaaha-ms-6999] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
The guidelines are an update and extension of the AAHA Canine Life Stage Guidelines published in 2012. A noteworthy change from the earlier guidelines is the division of the dog’s lifespan into five stages (puppy, young adult, mature adult, senior, and end of life) instead of the previous six. This simplified grouping is consistent with how pet owners generally perceive their dog’s maturation and aging process and provides a readily understood basis for an evolving, lifelong healthcare strategy. The guidelines provide the following recommendations for managing 10 health-related factors at each of the first four canine life stages: lifestyle effect on the patient’s safety, zoonotic and human safety risk, behavior, nutrition, parasite control, vaccination, dental health, reproduction, breed-specific conditions, and a baseline diagnostic profile.
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Affiliation(s)
- Kate E. Creevy
- From the Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, Texas (K.E.C.); Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi (J.G.); Oklahoma State University, Department of Veterinary Pathobiology, Stillwater, Oklahoma (S.E.L.); Depar
| | - Jesse Grady
- From the Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, Texas (K.E.C.); Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi (J.G.); Oklahoma State University, Department of Veterinary Pathobiology, Stillwater, Oklahoma (S.E.L.); Depar
| | - Susan E. Little
- From the Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, Texas (K.E.C.); Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi (J.G.); Oklahoma State University, Department of Veterinary Pathobiology, Stillwater, Oklahoma (S.E.L.); Depar
| | - George E. Moore
- From the Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, Texas (K.E.C.); Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi (J.G.); Oklahoma State University, Department of Veterinary Pathobiology, Stillwater, Oklahoma (S.E.L.); Depar
| | - Beth Groetzinger Strickler
- From the Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, Texas (K.E.C.); Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi (J.G.); Oklahoma State University, Department of Veterinary Pathobiology, Stillwater, Oklahoma (S.E.L.); Depar
| | - Steve Thompson
- From the Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, Texas (K.E.C.); Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi (J.G.); Oklahoma State University, Department of Veterinary Pathobiology, Stillwater, Oklahoma (S.E.L.); Depar
| | - Jinelle A. Webb
- From the Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, Texas (K.E.C.); Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi (J.G.); Oklahoma State University, Department of Veterinary Pathobiology, Stillwater, Oklahoma (S.E.L.); Depar
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Park KY, Park HK, Hwang HS, Ryu JS, Lee KG, Jang KS. Space Occupying Lesion in the Liver Caused by Hepatic Visceral Larva Migrans: A Case Report. Am J Trop Med Hyg 2019; 99:1602-1605. [PMID: 30277205 DOI: 10.4269/ajtmh.18-0199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Visceral larva migrans (VLM) is one of the clinical syndromes of human toxocariasis. We report a case of hepatic VLM presenting preprandial malaise and epigastric discomfort in a 58-year-old woman drinking raw roe deer blood. The imaging studies of the abdomen showed a 74-mm hepatic mass featuring hepatic VLM. Anti-Toxocara canis immunoglobulin G (IgG) was observed in enzyme-linked immunosorbent assay (ELISA) and western blot. Despite anthelmintic treatment, the patient complained of newly developed cough and skin rash with severe eosinophilia. Hepatic lesion increased in size. The patient underwent an open left lobectomy of the liver. After the surgery, the patient was free of symptoms such as preprandial malaise, epigastric discomfort, cough, and skin rash. Laboratory test showed a normal eosinophilic count at postoperative 1 month, 6 months, 1 year, and 4 years. The initial optical density value of 2.55 of anti-T. canis IgG in ELISA was found to be negative (0.684) at postoperative 21 months. Our case report highlights that a high degree of clinical suspicion for hepatic VLM should be considered in a patient with a history of ingestion of raw food in the past, presenting severe eosinophilia and a variety of symptoms which reflect high worm burdens. Symptom remission, eosinophilia remission, and complete radiological resolution of lesions can be complete with surgery.
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Affiliation(s)
- Kye-Yeung Park
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hoon-Ki Park
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hwan-Sik Hwang
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jae-Sook Ryu
- Department of Environmental Biology and Medical Parasitology, Hanyang University College of Medicine, Seoul, Korea
| | - Kyeong-Geun Lee
- Department of Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Ki-Seok Jang
- Department of Pathology Hanyang University College of Medicine, Seoul, Korea
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Maleki B, Khorshidi A, Gorgipour M, Mirzapour A, Majidiani H, Foroutan M. Prevalence of Toxocara spp. eggs in soil of public areas in Iran: A systematic review and meta-analysis. ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2017.06.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Bahman Maleki
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IranDepartment of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Khorshidi
- Department of Epidemiology, School of Medicine, Ilam University of Medical Sciences, Ilam, IranDepartment of Epidemiology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Mohammad Gorgipour
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IranDepartment of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Aliyar Mirzapour
- Department of Parasitology and Mycology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranDepartment of Parasitology and Mycology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Majidiani
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IranDepartment of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Masoud Foroutan
- Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IranDepartment of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Molina B, González-Vicent M, Valls I, Díaz MÁ. Ocular toxocariasis in a pediatric patient undergoing a bone marrow transplantation. Enferm Infecc Microbiol Clin 2018; 37:617-618. [PMID: 30360919 DOI: 10.1016/j.eimc.2018.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/12/2018] [Accepted: 09/08/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Blanca Molina
- Stem Cell Transplant Unit, Hospital Niño Jesús, Madrid, Spain
| | | | - Isabel Valls
- Ophthalmology Section, Hospital Niño Jesús, Madrid, Spain
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Chou CM, Fan CK. Significant apoptosis rather autophagy predominates in astrocytes caused by Toxocara canis larval excretory-secretory antigens. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2018; 53:250-258. [PMID: 30033092 DOI: 10.1016/j.jmii.2018.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 06/20/2018] [Accepted: 06/22/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND/PURPOSE Toxocariasis is a worldwide parasitic zoonosis and mainly caused by Toxocara canis. Humans can be infected by accidental ingestion of T. canis embryonated ova through contacting with contaminated food, water, or encapsulated larvae in paratenic hosts' viscera or meat. Since humans are the paratenic host of T. canis, the wandering and neuroinvasive larvae can cause mechanical tissue damage and the excretory-secretory antigens (TcES Ag) might induce neuroinflammatory responses in the brain. Human cerebral toxocariasis (CT) has been reported to cause several neurological symptoms and may develop into neurodegenerative diseases. However, the roles of astrocytes involved in the pathogenesis of CT remained largely unclear. METHODS This study intended to investigate the cytotoxic effects of TcES Ag on astrocytes as assessed by apoptosis and autophagy expression. RESULTS Our results showed TcES Ag treatment reduced cell viability and caused morphological changes. Expressions of autophagy associated proteins including Beclin 1, phosphor-mTOR and LC3-Ⅱ were not significantly changed; however, p62 as well as the cell survival protein, mTOR, was concomitantly decreased in TcES Ag treatment. Significantly accelerated cleaved caspase-3 and cytochrome c expression as well as enhanced caspase-9 and caspase-8 activation were found in astrocytes with TcES Ag treatment. Caspase-3 activity and apoptotic cells numbers were also increased as detected by fluorescence microscopy. CONCLUSION We concluded that TcES Ag may trigger astrocytes apoptosis predominantly through intrinsic and extrinsic pathways rather autophagy, revealing a novel role of astrocytes in the pathogenesis of CT.
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Affiliation(s)
- Chia-Mei Chou
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, 250 Wuxing St., Taipei 11031, Taiwan; Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing St., Taipei 11031, Taiwan
| | - Chia-Kwung Fan
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, 250 Wuxing St., Taipei 11031, Taiwan; Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing St., Taipei 11031, Taiwan; Research Center of International Tropical Medicine, College of Medicine, Taipei Medical University, 250 Wuxing St., Taipei 11031, Taiwan; Tropical Medicine Division, International PhD Program in Medicine, College of Medicine, Taipei Medical University, 250 Wuxing St., Taipei 11031, Taiwan.
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Taetzsch SJ, Gruszynski KR, Bertke AS, Dubey JP, Monti KA, Zajac AM, Lindsay DS. Prevalence of zoonotic parasites in feral cats of Central Virginia, USA. Zoonoses Public Health 2018; 65:728-735. [DOI: 10.1111/zph.12488] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 04/15/2018] [Accepted: 05/27/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Sara J. Taetzsch
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine; Virginia Tech; Blacksburg Virginia
- Feral Cat Trap-Neuter-Release Clinics; Mechanicsville Virginia
| | | | - Andrea S. Bertke
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine; Virginia Tech; Blacksburg Virginia
| | - Jitender P. Dubey
- Animal Parasitic Diseases Laboratory, Agricultural Research Service, US Department of Agriculture; Beltsville Agricultural Research Center; Beltsville Maryland
| | - Katelynn A. Monti
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine; Virginia Tech; Blacksburg Virginia
| | - Anne M. Zajac
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine; Virginia Tech; Blacksburg Virginia
| | - David S. Lindsay
- Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine; Virginia Tech; Blacksburg Virginia
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Wang Z, Shibata M, Nguyen YTH, Hayata Y, Nonaka N, Maruyama H, Yoshida A. Development of nested multiplex polymerase chain reaction (PCR) assay for the detection of Toxocara canis, Toxocara cati and Ascaris suum contamination in meat and organ meats. Parasitol Int 2018; 67:622-626. [PMID: 29920343 DOI: 10.1016/j.parint.2018.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 06/14/2018] [Accepted: 06/15/2018] [Indexed: 12/15/2022]
Abstract
Ascarid Larva Migrans Syndrome (ascarid LMS) is a clinical syndrome in humans, caused by the migration of animal roundworm larvae such as Toxocara canis, Toxocara cati and Ascaris suum. Humans may acquire infection by ingesting embryonated eggs, or infective larvae of these parasites in contaminated meat and organ meats. To detect these pathogenic contaminations, a novel nested multiplex PCR system was developed. Our novel nested multiplex PCR assay showed specific amplification of T. canis, T. cati and Ascaris spp. Detection limit of the nested multiplex PCR was tested with serial dilution of T. canis, T. cati or A. suum genomic DNA (gDNA) from 100 pg to 100 ag and found to be 10 fg, 1 fg and 100 fg, respectively. When larvae were spiked into chicken liver tissue, DNA of T. canis and A. suum was detected from the liver spiked with a single larva, while the assay required at least 2 larvae of T. cati. Moreover, the ascarid DNA was detected from the liver of mice infected with 100 and 300 eggs of T. canis, T. cati or A. suum. This nested multiplex PCR assay could be useful for the detection of contamination with ascarid larvae in meat and organ meats.
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Affiliation(s)
- Zhenzhen Wang
- Division of Parasitology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake-cho, Miyazaki 889-1692, Japan
| | - Miho Shibata
- Division of Parasitology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake-cho, Miyazaki 889-1692, Japan
| | - Yen Thi Hoang Nguyen
- Laboratory of Veterinary Parasitic Diseases, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, 1-1, Gakuen-Kibanadai Nishi, Miyazaki 889-2192, Japan; Department of Parasitology, Faculty of Veterinary medicine, Vietnam National University of Agriculture, Trau Quy, Gia Lam, Ha Noi, Viet Nam
| | - Yayoi Hayata
- Laboratory of Veterinary Parasitic Diseases, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, 1-1, Gakuen-Kibanadai Nishi, Miyazaki 889-2192, Japan
| | - Nariaki Nonaka
- Laboratory of Veterinary Parasitic Diseases, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, 1-1, Gakuen-Kibanadai Nishi, Miyazaki 889-2192, Japan
| | - Haruhiko Maruyama
- Division of Parasitology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake-cho, Miyazaki 889-1692, Japan
| | - Ayako Yoshida
- Division of Parasitology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake-cho, Miyazaki 889-1692, Japan; Laboratory of Veterinary Parasitic Diseases, Department of Veterinary Sciences, Faculty of Agriculture, University of Miyazaki, 1-1, Gakuen-Kibanadai Nishi, Miyazaki 889-2192, Japan.
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40
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[Zoonotic intestinal nematodes in dogs from public parks in Yucatán, México]. BIOMEDICA 2018; 38:105-110. [PMID: 29668139 DOI: 10.7705/biomedica.v38i0.3595] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 01/19/2017] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Dogs represent a potential public health risk because of the natural transmission of zoonotic parasitic infections. OBJECTIVE To estimate the frequency and to determine factors associated with the presence of intestinal nematode eggs in dog feces collected in public parks of Mérida,Yucatán, México. MATERIALS AND METHODS A total of 100 dog fecal samples collected from 20 public parks in two areas of Mérida were analyzed. Samples were processed by the centrifugation-flotation and the McMaster techniques to confirm the presence and to quantify the excretion of intestinal nematode eggs per gram of feces. The factors associated with the presence of nematode eggs were identified using the chi square univariate analysis. RESULTS We found an 11% frequency of fecal samples positive for intestinal nematode eggs. Eggs of three species of parasites were identified: Ancylostoma caninum was the most common (10%), followed by Toxocara canis (10%), and Trichuris vulpis (1%). Most positive samples were infected with only one intestinal nematode (10%), and only 1 % was positive for a mixed infection by A. caninum and T. vulpis. The presence of stray dogs in public parks was an associated factor (p=0.046) with a higher number of fecal samples positive for intestinal nematode eggs. CONCLUSIONS The frequency of intestinal nematodes in dog feces with zoonotic potential was high in parks of Mérida, Yucatán, México; samples from parks where there were stray dogs had a higher possibility of being positive.
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Taetzsch SJ, Bertke AS, Gruszynski KR. Zoonotic disease transmission associated with feral cats in a metropolitan area: A geospatial analysis. Zoonoses Public Health 2018; 65:412-419. [PMID: 29423934 DOI: 10.1111/zph.12449] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Indexed: 12/17/2022]
Abstract
Feral cats raise public health concerns due to their large population numbers and ability to harbour pathogens that cause disease in people, pets, and wildlife. Information regarding the potential for feral cats to intersect with areas frequented by humans is lacking. This study examined the potential for feral cats and human territories to overlap in the Richmond metropolitan area of Central Virginia. Feral cats (n = 275) were trapped for monthly trap-neuter-release (TNR) clinics from July to November 2016. A geographic information system (GIS) was used to map feral cat trapping locations, elementary and preschools, public parks, and community gardens, and to evaluate the potential for cat interaction with these areas, presuming a maximum habitat radius of 0.44 miles. We found that 8.0% of feral cats in the Richmond metropolitan area had potential to range onto public elementary or preschool property, and 81.5% of feral cats trapped in Richmond City had potential to roam into one or more places of interest, including elementary and preschool grounds, public parks, and community gardens. This provides public health, veterinary, and human health professionals with important information that can be used to focus resources in an effort to reduce zoonosis associated with feral cat populations.
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Affiliation(s)
- S J Taetzsch
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
| | - A S Bertke
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
| | - K R Gruszynski
- Virginia Department of Health, Office of Epidemiology, Richmond, VA, USA
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Ma G, Holland CV, Wang T, Hofmann A, Fan CK, Maizels RM, Hotez PJ, Gasser RB. Human toxocariasis. THE LANCET. INFECTIOUS DISEASES 2018; 18:e14-e24. [PMID: 28781085 DOI: 10.1016/s1473-3099(17)30331-6] [Citation(s) in RCA: 249] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 04/21/2017] [Accepted: 05/11/2017] [Indexed: 12/25/2022]
Abstract
Parasitic nematodes of the genus Toxocara are socioeconomically important zoonotic pathogens. These parasites are usually directly transmitted to the human host via the faecal-oral route and can cause toxocariasis and associated complications, including allergic and neurological disorders. Although tens of millions of people are estimated to be exposed to or infected with Toxocara spp, global epidemiological information on the relationship between seropositivity and toxocariasis is limited. Recent findings suggest that the effect of toxocariasis on human health is increasing in some countries. Here we review the salient background on Toxocara and biology, summarise key aspects of the pathogenesis, diagnosis, and treatment of toxocariasis, describe what is known about its geographic distribution and prevalence, and make some recommendations for future research towards the prevention and control of this important disease.
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Affiliation(s)
- Guangxu Ma
- Department of Veterinary Biosciences, Melbourne Veterinary School, The University of Melbourne, Parkville, VIC, Australia
| | - Celia V Holland
- Department of Zoology, School of Natural Sciences, Trinity College, Dublin, Ireland
| | - Tao Wang
- Department of Veterinary Biosciences, Melbourne Veterinary School, The University of Melbourne, Parkville, VIC, Australia
| | - Andreas Hofmann
- Griffith Institute for Drug Discovery, Griffith University, Nathan, QLD, Australia
| | - Chia-Kwung Fan
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine & Research Center of International Tropical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Rick M Maizels
- Wellcome Centre for Molecular Parasitology, Institute for Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - Peter J Hotez
- Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Department of Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Robin B Gasser
- Department of Veterinary Biosciences, Melbourne Veterinary School, The University of Melbourne, Parkville, VIC, Australia.
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Barahona Botache GS, Olivera MJ. Ocular toxocariasis caused by toxocara canis in an adult woman. Case report. CASE REPORTS 2018. [DOI: 10.15446/cr.v4n1.65310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. La toxocariasis es una zoonosis producida por las larvas de los nematodos Toxocara canis y Toxocara cati, parásitos intestinales de los cánidos y los félidos, respectivamente.Presentación del caso. Paciente femenino de 22 años de edad, procedente de Caquetá, Colombia, con un cuadro de 3 meses de evolución con pérdida de visión en ojo izquierdo, acompañada de dolor ocular, diplopía, fotofobia y ojo rojo bilateral, quien presenta desprendimiento de retina en ojo izquierdo diagnosticado por ecografía. La mujer asiste a oftalmología, donde se hace diagnóstico diferencial con retinoblastoma y pars planitis. Se inicia manejo sintomático con corticoides orales y tópicos, con mejoría de la sintomatología, pero persistencia de pérdida de la agudeza visual.Discusión. Al revisar historial de antecedentes socioeconómicos, la paciente convive con perros y gatos, por lo que se piensa en toxocariasis ocular. En el cuadro hemático se observa ligera leucocitosis y linfocitosis, sin eosinofilia. La determinación de anticuerpos anti-Toxoplasma gondii y anti-cisticerco de Taenia solium resultaron negativas, al igual que el VDRL. El test de ELISA para T. canis fue positivo, con unos títulos IgG de 1:64 (positivo ≥1:32, especificidad >90%). Se inicia manejo con corticoide oftálmico, sistémico, albendazol y vitrectomía. Con la intervención quirúrgica se libera banda vítrea, logrando la desaparición de la diplopía, pero persiste granuloma periférico residual, el cual será intervenido por oftalmología.Conclusiones. Dada la posibilidad de ser confundida con un retinoblastoma —una neoplasia maligna que puede requerir la enucleación del ojo—, el conocimiento de esta forma de presentación de la toxocariasis es de suma importancia para los clínicos.
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Chou CM, Lee YL, Liao CW, Huang YC, Fan CK. Enhanced expressions of neurodegeneration-associated factors, UPS impairment, and excess Aβ accumulation in the hippocampus of mice with persistent cerebral toxocariasis. Parasit Vectors 2017; 10:620. [PMID: 29273062 PMCID: PMC5741903 DOI: 10.1186/s13071-017-2578-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 12/06/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Toxocariasis is a worldwide zoonotic parasitic disease mainly caused by Toxocara canis. Humans can be infected by accidental ingestion of T. canis embryonated ovum-contaminated food, water, or encapsulated larvae in paratenic hosts' viscera or meat. Since humans and mice are paratenic hosts of T. canis, the wandering larvae might cause mechanical tissue damage and excretory-secretory antigens may trigger inflammatory injuries to local organs. Long-term residence of T. canis larvae in a paratenic host's brain may cause cerebral toxocariasis (CT) that contributes to cerebral damage, neuroinflammation and neuropsychiatric disorders in mice and clinical patients. Since the hippocampus has been long recognized as being responsible for learning and memory functions, parasitic invasion of this site may cause neuroinflammatory and neurodegenerative disorders. The present study intended to assess pathological changes, expressions of neurodegeneration-associated factors (NDAFs), including transforming growth factor (TGF)-β1, S100B, glial fibrillary acidic protein (GFAP), transglutaminase type 2 (TG2), claudin-5, substance P (SP) and interleukin (IL)-1β, and the ubiquitin-proteasome system (UPS) function in the hippocampus and associated cognitive behavior in ICR mice orally inoculated with a high, medium or low-dose of T. canis embryonated ova during a 20-week investigation. RESULTS Results indicated although there were insignificant differences in learning and memory function between the experimental mice and uninfected control mice, possibly because the site where T. canis larvae invaded was the surrounding area but not the hippocampus per se. Nevertheless, enhanced expressions of NDAF, persistent UPS impairment and excess amyloid β (Aβ) accumulation concomitantly emerged in the experimental mice hippocampus at 8, 16 and 20 weeks post-infection. CONCLUSIONS We thus postulate that progressive CT may still progress to neurodegeneration due to enhanced NDAF expressions, persistent UPS impairment and excess Aβ accumulation in the hippocampus.
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Affiliation(s)
- Chia-Mei Chou
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, 250 Wuxing St, Taipei, 11031, Taiwan.,Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing St, Taipei, 11031, Taiwan
| | - Yueh-Lun Lee
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing St, Taipei, 11031, Taiwan
| | - Chien-Wei Liao
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing St, Taipei, 11031, Taiwan.,Research Center of International Tropical Medicine, College of Medicine, Taipei Medical University, 250 Wuxing St, Taipei, 11031, Taiwan
| | - Ying-Chieh Huang
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing St, Taipei, 11031, Taiwan
| | - Chia-Kwung Fan
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, 250 Wuxing St, Taipei, 11031, Taiwan. .,Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing St, Taipei, 11031, Taiwan. .,Research Center of International Tropical Medicine, College of Medicine, Taipei Medical University, 250 Wuxing St, Taipei, 11031, Taiwan. .,Tropical Medicine Division, International PhD Program in Medicine, College of Medicine, Taipei Medical University, 250 Wuxing St, Taipei, 11031, Taiwan.
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Trehalose-6-phosphate phosphatase as a broad-spectrum therapeutic target against eukaryotic and prokaryotic pathogens. Emerg Top Life Sci 2017; 1:675-683. [DOI: 10.1042/etls20170106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 09/13/2017] [Accepted: 09/21/2017] [Indexed: 11/17/2022]
Abstract
As opposed to organism-based drug screening approaches, protein-based strategies have the distinct advantage of providing insights into the molecular mechanisms of chemical effectors and thus afford a precise targeting. Capitalising on the increasing number of genome and transcriptome datasets, novel targets in pathogens for therapeutic intervention can be identified in a more rational manner when compared with conventional organism-based methodologies. Trehalose-6-phosphate phosphatases (TPPs) are structurally and functionally conserved enzymes of the trehalose biosynthesis pathway which play a critical role for pathogen survival, in particular, in parasites. The absence of these enzymes and trehalose biosynthesis from mammalian hosts has recently given rise to increasing interest in TPPs as novel therapeutic targets for drugs and vaccines. Here, we summarise some key aspects of the current state of research towards novel therapeutics targeting, in particular, nematode TPPs.
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46
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Berrett AN, Erickson LD, Gale SD, Stone A, Brown BL, Hedges DW. Toxocara Seroprevalence and Associated Risk Factors in the United States. Am J Trop Med Hyg 2017; 97:1846-1850. [PMID: 29016316 DOI: 10.4269/ajtmh.17-0542] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Caused by the parasitic nematodes Toxocara canis and cati, toxocariasis in humans can result in covert toxocariasis, ocular toxocariasis, visceral larval migrans, and neurotoxocariasis. A common infection, toxocariasis exposure varies widely within and between countries, with a previous estimate of Toxocara seroprevalence using data from 1988 to 1994 in the United States of approximately 13%. Age, poverty, sex, educational attainment, ethnicity, and region have been associated with Toxocara seroprevalence. In this study, we sought to determine the seroprevalence of and factors associated with Toxocara seropositivity in the United States using data from the National Health and Nutrition Examination Survey from 2011 to 2014 to provide a more recent estimate of Toxocara seroprevalence in the United States. We found an overall Toxocara seroprevalence of 5.1%. Increasing age, male sex, low educational attainment, low income, and immigration status each was associated with Toxocara seropositivity. Mexican Americans had reduced odds of exposure. These findings show that exposure to Toxocara continues in the United States and that several demographic factors influence the risk of exposure.
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Affiliation(s)
| | | | - Shawn D Gale
- The Neuroscience Center, Brigham Young University, Provo, Utah.,Department of Psychology, Brigham Young University, Provo, Utah
| | - Allison Stone
- Department of Psychology, Brigham Young University, Provo, Utah
| | - Bruce L Brown
- Department of Psychology, Brigham Young University, Provo, Utah
| | - Dawson W Hedges
- Department of Psychology, Brigham Young University, Provo, Utah.,The Neuroscience Center, Brigham Young University, Provo, Utah
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Bonnefond S, Foucher A, Zunic P, Hoarau G, Magnaval JF. Atypical presentation of hepatic visceral larva migrans mimicking cancer and associated with ADAMTS13 deficiency-mediated thrombotic microangiopathy: A first report from Reunion Island. PLoS Negl Trop Dis 2017; 11:e0005617. [PMID: 28727752 PMCID: PMC5518999 DOI: 10.1371/journal.pntd.0005617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Simon Bonnefond
- Department of Internal Medicine and Infectious Diseases, Centre Hospitalier Universitaire de la Réunion Saint Pierre, Reunion Island, France
| | - Aurélie Foucher
- Department of Internal Medicine and Infectious Diseases, Centre Hospitalier Universitaire de la Réunion Saint Pierre, Reunion Island, France
| | - Patricia Zunic
- Department of Hematology, Centre Hospitalier Universitaire de la Reunion Saint Pierre, Reunion Island, France
| | - Gautier Hoarau
- Department of Microbiology, Centre Hospitalier Universitaire de la Reunion Saint Pierre, Reunion Island, France
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Wyrosdick HM, Chapman A, Martinez J, Schaefer JJ. Parasite prevalence survey in shelter cats in Citrus County, Florida. VETERINARY PARASITOLOGY- REGIONAL STUDIES AND REPORTS 2017; 10:20-24. [PMID: 31014592 DOI: 10.1016/j.vprsr.2017.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 06/20/2017] [Accepted: 07/09/2017] [Indexed: 11/29/2022]
Abstract
Free-roaming cat population estimates within the United States currently range from 10 to 114million individual cats. Zoonotic parasites of free-roaming cats are public health concerns; therefore, it is important to investigate the parasite prevalence in these populations. Seventy-six fecal samples from shelter cats in Citrus County, FL were surveyed for parasites using the Sheather's sugar centrifugal flotation method. The objective was to determine the prevalence of patent gastrointestinal parasitism in the sampled shelter cats as a proxy for parasite prevalence in the free-roaming cat populations in the area. Parasites identified with zoonotic potential include Toxocara cati, Ancylostoma sp., Spirometra sp., Mesocestoides sp., Cryptosporidium sp., and Giardia sp. Both tapeworms detected can infect humans, but are not directly transmissible from cats to people. Other parasite diagnostic stages found included Aonchotheca putorii eggs, Cystoisospora felis and Cystoisospora rivolta oocysts, and Sarcocystis sp. sporocysts. The mites Lynxacarus radovskyi and Notoedres cati were detected in feces likely from ingestion while grooming.
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Affiliation(s)
- Heidi M Wyrosdick
- University of Tennessee, Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, 2407 River Dr., Knoxville, TN 37996, USA.
| | - Alycia Chapman
- University of Tennessee, Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, 2407 River Dr., Knoxville, TN 37996, USA
| | - Jessica Martinez
- University of Tennessee, Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, 2407 River Dr., Knoxville, TN 37996, USA
| | - John J Schaefer
- University of Tennessee, Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, 2407 River Dr., Knoxville, TN 37996, USA
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49
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Cross M, Rajan S, Chekaiban J, Saunders J, Hamilton C, Kim JS, Coster MJ, Gasser RB, Hofmann A. Enzyme characteristics of pathogen-specific trehalose-6-phosphate phosphatases. Sci Rep 2017; 7:2015. [PMID: 28515463 PMCID: PMC5435700 DOI: 10.1038/s41598-017-02220-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 04/07/2017] [Indexed: 12/21/2022] Open
Abstract
Owing to the key role of trehalose in pathogenic organisms, there has recently been growing interest in trehalose metabolism for therapeutic purposes. Trehalose-6-phosphate phosphatase (TPP) is a pivotal enzyme in the most prominent biosynthesis pathway (OtsAB). Here, we compare the enzyme characteristics of recombinant TPPs from five important nematode and bacterial pathogens, including three novel members of this protein family. Analysis of the kinetics of trehalose-6-phosphate hydrolysis reveals that all five enzymes display a burst-like kinetic behaviour which is characterised by a decrease of the enzymatic rate after the pre-steady state. The observed super-stoichiometric burst amplitudes can be explained by multiple global conformational changes in members of this enzyme family during substrate processing. In the search for specific TPP inhibitors, the trapping of the complex conformational transitions in TPPs during the catalytic cycle may present a worthwhile strategy to explore.
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Affiliation(s)
- Megan Cross
- Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, 4111, Australia
| | - Siji Rajan
- Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, 4111, Australia
| | - Janine Chekaiban
- Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, 4111, Australia
| | - Jake Saunders
- Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, 4111, Australia
| | - Chloe Hamilton
- Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, 4111, Australia
| | - Jeong-Sun Kim
- Department of Chemistry, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Mark J Coster
- Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, 4111, Australia
| | - Robin B Gasser
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Andreas Hofmann
- Griffith Institute for Drug Discovery, Griffith University, Nathan, Queensland, 4111, Australia.
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, 3010, Australia.
- Queensland Tropical Health Alliance, Smithfield, Queensland, 4878, Australia.
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Kollipara R, Peranteau AJ, Nawas ZY, Tong Y, Woc-Colburn L, Yan AC, Lupi O, Tyring SK. Emerging infectious diseases with cutaneous manifestations: Fungal, helminthic, protozoan and ectoparasitic infections. J Am Acad Dermatol 2017; 75:19-30. [PMID: 27317513 DOI: 10.1016/j.jaad.2016.04.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 04/11/2016] [Accepted: 04/12/2016] [Indexed: 12/27/2022]
Abstract
Given increased international travel, immigration, changing climate conditions, and the increased incidence of iatrogenic immunosuppression, fungal, protozoan, helminthic, and ectoparasitic infections that were once uncommon are being seeing more frequently in the Western hemisphere. However, the diagnosis and management of these infections is fraught with a lack of consistency because there is a dearth of dermatology literature on the cutaneous manifestations of these infections. In addition, delays in the diagnosis and treatment of these diseases can lead to significant patient morbidity and mortality. We review the epidemiology, cutaneous manifestations, diagnostic modalities, and treatment options for emerging fungal, protozoan, helminthic, and ectoparasitic infections. It should be noted, however, that throughout this review we cite statistics documenting their increased incidence to back-up these infections as emerging, and although some of the diagnoses are clinical, others rely on newer laboratory tests, and the possibility exists that the increased incidence could be caused by better detection methods.
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Affiliation(s)
- Ramya Kollipara
- Department of Dermatology, Texas Tech Health Sciences Center, Lubbock, Texas
| | | | | | - Yun Tong
- Center for Clinical Studies, Houston, Texas
| | - Laila Woc-Colburn
- Section of Infectious Diseases, Department of Medicine, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas
| | - Albert C Yan
- Section of Dermatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Omar Lupi
- Federal University of the State of Rio de Janeiro and Policlinica Geral do Rio de Janeiro, Rio de Janerio, Brazil
| | - Stephen K Tyring
- Center for Clinical Studies, Houston, Texas; Department of Dermatology, University of Texas Health Science Center, Houston, Texas
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