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Distribution of Toxocara infection in the environment and in definitive and paratenic hosts in Estonia.

The aim of the study was to elucidate the distribution and possible transmission routes of Toxocara spp. infection in Estonia. Out of 454 faecal and sand samples collected from park lawns and sandpits in the town of Tartu, 19 were Toxocara positive (4.2%). Out of the 45 sandpit samples 17.8% were Toxocara positive. Cat faeces was found in 21 sandpit samples. Parasitological necropsies were performed on 41 euthanised stray dogs and 27 cats in the Tallinn Dog Home. Additionally, 13 wild free-roaming brown rats (Rattus norvegicus) were captured from the Tallinn Dog Home territory, necropsied and studied for the presence of Toxocara larvae. Toxocara canis adults were found in 14.6% of the dogs and Toxocara cati (syn. mystax) adults in the small intestines of 48.2% of the cats examined. Larval infection was detected in the kidney and liver in 5 dogs (12.2%). Our study demonstrated only low-level larval Toxocara infections in adult dogs. Toxocara larvae were not found in cats and brown rats. According to the results of this study, cats more often carry Toxocara infection than dogs. Under our conditions, stray and free-roaming cats are the main contaminators of the environment with Toxocara eggs. Children playing in sandpits are the main risk group for larval toxocarosis.

Animals↗

Relationship between allergic manifestations and Toxocara seropositivity: a cross-sectional study among elementary school children.

Toxocara (the cause of visceral larva migrans in humans) and allergy have in common both elevated immunoglobulin E (IgE) levels and eosinophilia. In the present study, we investigated: 1) associations between Toxocara seropositivity and allergic manifestations; 2) risk factors for Toxocara infection; and 3) differences in Toxocara seroprevalence, allergic manifestations and the associations between these two, in children from urban and rural environments. Blood samples from 1,379 Dutch urban and rural elementary schoolchildren, were examined for Toxocara antibodies, eosinophil numbers, total IgE concentrations, and the occurrence of inhaled allergen-specific IgE. Questionnaires investigating respiratory health and putative risk factors for infection were completed. It was found that 8% of the children had Toxocara antibodies, occurring significantly less often in females than in males. The means of total serum IgE levels and blood eosinophils were significantly higher in the Toxocara-seropositive than in the seronegative group. Allergic asthma/recurrent bronchitis was found in 7% of the children, allergic reaction on animal contact in 4%, and IgE to at least one inhaled allergen in 16%. These variables were associated with Toxocara seroprevalence. Inhaled allergen-specific IgE and asthma/recurrent bronchitis occurred significantly less often in rural than in urban areas, and significantly less often among girls than among boys. Furthermore, occurrence of allergen-specific IgE increased significantly with age. No association existed between Toxocara seroprevalence and assumed risks, i.e. contact with pet animals and public playgrounds. In conclusion, our results indicate that allergic manifestations occur more often in Toxocara-seropositive children. A relationship with an already existing allergic condition is plausible.

Animals↗

The frequency of Toxocara infection in mental retarded children.

Human toxocariasis is commonly seen in places where stray and Toxocara canis-infected dog population is high. There is a strong correlation between frequency of Toxocara infection, life style, and infection risk. Institutionalization of mental retarded patients increases to risk of toxocariasis. In this study, we aimed at investigating the frequency of Toxocara infection among children with mental retardation not requiring institutionalization. The study included 96 cases, who had educatable mental retardation and 85 healthy subjects who comprised the control group. Anti-Toxocara IgG or IgM antibodies were investigated in all serum samples, using ELISA method. The frequency of Toxocara infection was found significantly higher in mental retarded cases than in those in the control group (18.8% and 7.1% respectively) (p < 0.05). There was no significant difference between mental retarded children and the control group in terms of mean age, age groups, gender, owning dogs and cats and duration of their ownership, socio-economic level and behavioural factors, and personal hygiene (p > 0.05). We did not find any significant difference between Toxocara seropositive and seronegative mental retarded children in terms of demographic factors and epidemiological factors that could increase the risk of Toxocara infection (p > 0.05). The present study is the first seroprevalence study carried out with a mental retarded group not requiring institutionalization. Determination of high frequency of Toxocara infection suggests that these subjects constitute a risk factor for Toxocara infection, which may be attributed to their behavioural patterns.

Adolescent↗

Seroprevalence of Toxocara antibodies in patients with adult asthma.

Toxocariasis is a common worldwide infection. Asthma, considered to be one of the most common chronic diseases, is a serious global health problem. Toxocara may be a possible etiologic agent of asthma. The aim of this study was to investigate whether there is an association between adult asthma and Toxocara seroprevalence. Fifty three adult patients with asthma participated in the study. All patients had an age of disease onset of 20 years or older. Blood samples were tested for the presence of Toxocara antibodies using enzyme-linked immunosorbent assay (ELISA). We found a 13.2% Toxocara seropositivity for asthma. There was a significant difference in the Toxocara seropositivity between adult asthma patients and our healthy cohort populations. There was no significant difference between Toxocara seropositive asthma and Toxocara seronegative asthma in terms of the risk factors for Toxocara infection. We believe that further research with a large number of asthma patients is warranted and preventive strategies in this patient population are needed.

Adult↗

Human toxocariasis: frequency of anti-Toxocara antibodies in children and adolescents from an outpatient clinic for lymphatic filariasis in Recife, Northeast Brazil.

In a transversal study on a sample of 386 children and adolescents from an outpatient clinic for filariasis in Recife, Northeast Brazil, the frequency of anti-Toxocara antibodies and its relation to age, gender, number of peripheral eosinophils, Wuchereria bancrofti microfilariae and intestinal helminths was determined. The total anti-Toxocara IgG antibody frequency was 39.4%, by ELISA technique. The difference in frequency between males (40.1%) and females (37.6%) was not statistically significant. The 6 to 10-year-old subset presented the highest frequency of anti-Toxocara antibodies (60%), and within this age group there was a statistically significant male bias. There was also a significant association between the number of eosinophils and the presence of anti-Toxocara antibodies. Intestinal parasite frequency was 52.1%, but no association was found between this data and the presence of anti-Toxocara antibodies. In the present sample, 42.2% of the patients were Wuchereria bancrofti carriers, however, again this was not associated with the presence of anti-Toxocara antibodies. In conclusion, anti-Toxocara antibodies were highly prevalent in this sample. The present data show that there is no cross correlation between anti-Toxocara IgG antibody and the presence of intestinal helminths and filariasis.

Adolescent↗

Environmental exposure to Toxocara as a possible risk factor for asthma: a clinic-based case-control study.

The zoonotic ascarid Toxocara has been suggested as a possible etiologic agent of asthma. We conducted a clinic-based case-control study to examine whether the zoonotic infection acquired by ingesting Toxocara eggs is associated with asthma in children. Blood samples were collected from children aged 2-15 years, 95 of whom had asthma and 229 of whom did not have asthma. Risk factors for asthma and Toxocara infection were assessed by a questionnaire given to each child's parent or legal guardian. Blood samples were tested for the presence of Toxocara antibodies, using an enzyme-linked immunosorbent assay. No significant association was found between Toxocara infection and asthma. Significant associations were found between asthma and risk factors and between Toxocara infection and risk factors. High prevalence of Toxocara infection was noted among Hispanic children of Puerto Rican descent.

Adolescent↗

Intestinal nematodes, Toxocara infection, and pyogenic liver abscess in children: a possible association.

Eosinophilia and intestinal helminths are frequent in children with pyogenic liver abscess (PLA) diagnosed in Vitória (Brazil). For these reasons we hypothesized that nematode infection with larvae migrating through the tissues (Ascaris, Strongyloides, Ancylostoma, Necator and Toxocara) may be a predisposing factor for PLA in children. We compared the prevalence of intestinal helminth and Toxocara infection between children with PLA and a control group of children with no evidence of PLA at the Children's Hospital N.S. da Glória in Vitória. From October 1996 to February 1998, 13 children with PLA and 110 children with diseases other than PLA provided five stool samples (Hoffman, Baerman and Kato-Katz methods) and one blood sample for anti-Toxocara antibodies (ELISA IgG, with previous adsorption with Ascaris suum antigen). All PLA and comparison children belonged to a low socioeconomic class and lived in similar conditions. The frequency of intestinal nematodes and anti-Toxocara antibodies were significantly higher in PLA patients than in controls (intestinal helminths: 10/13 or 76.9 per cent in PLA cases and 31/110 or 28.1 per cent in controls; OR = 8.94; 95 per cent confidence interval (CI): 1.97 < OR < 50.06; anti-Toxocara antibodies: 9/13 or 69.2 per cent in PLA and 31/110 or 28.1 per cent in controls; OR = 6.59; 95 per cent CI: 1.65 < OR < 31.05). Moreover, the degree of eosinophilia was higher in PLA patients. Malnutrition was present in both groups. Hemoglobin was 9.5 g/dl in PLA patients and 9.7 g/dl in controls; p = 0.900. Serum levels of IgA and IgM were normal or above normal, with no difference between the two groups, but the levels of IgG and IgE were higher in PLA patients. Although there is some missing data in respect to some socioeconomic parameters in affected and comparison groups. these results support the hypothesis that helminth infection with larvae migrating through tissues may be a predisposing factor for PLA in children. Th2 cell activation and downregulation of Th1 cells, induced by helminths, thus reducing the microbicidal activity of phagocytes, as well as the granulomatous reaction around the larvae (mainly of Toxocara sp.) causing the trapping of bacteria in liver, may be possible explanations for the increased risk for PLA in children with intestinal nematodes and/or Toxocara infection.

Animals↗

[Toxocara and bronchial hyperreactivity--results of a seroprevalence study].

For more than 30 years the ascarid Toxocara canis, a parasite of the dog, has been considered a possible cause of allergic-pulmonal irritations (i.e. asthma bronchial) in man. According to a British study thousands of people are presumably suffering from asthma bronchial as a consequence of Toxocara infestations. The aim of our recent study was the assessment of the Toxocara seroprevalence in patients of varying bronchial reactivity and status of atopy suffering from respiratory disturbances. 191 serum samples from 59 male (mean age: 31.7 years) and 132 female patients (mean age: 36.6 years) with varying atopy status and degree of bronchial reactivity, living in or near Vienna, were examined for specific IgG antibodies against excretory-secretory (E/S) Toxocara canis antigen with enzyme-linked immunosorbent assay (TES-ELISA) and Western blot (TES-WB). In total a Toxocara seroprevalence of 9.4% could be assessed among these patients. 10% of the patients with and 7.8% of the patients without bronchial hyperreactivity were Toxocara-positive. Atopic patients were serologically positive in 7.1% of the cases tested whereas non-atopics showed an antibody prevalence of 14.3%. A comparison of Toxocara seroprevalence assessed within the recent study and in an earlier study among healthy pregnant women in Vienna did not show significant differences. The results of this study carried out in Vienna indicate that patients with bronchial hyper-reactivity or atopy show no higher seroprevalence than the normal population.

Adolescent↗

Toxocara seroprevalence in 5-year-old elementary schoolchildren: relation with allergic asthma.

Toxocara seroprevalence and the relation between Toxocara seroprevalence and allergic asthma were investigated in Dutch schoolchildren aged 4-6 years. Data on Toxocara antibodies, allergen-specific immunoglobulin E, allergic manifestations, and risk factors (pets and playgrounds) were obtained from 235 children from The Hague and 477 from Rotterdam, the Netherlands. The surveys were carried out from September 1987 to January 1988 in The Hague and in March and April 1989 in Rotterdam. Logistic regression was used to evaluate putative relations. Toxocara seroprevalence was higher in The Hague (11%) than in Rotterdam (6%), but this difference was not quite significant. Seroprevalences varied widely among schools. No differences between socioeconomic categories or between the sexes were found. Occurrences of asthma/recurrent bronchitis and hospitalization due to asthma/recurrent bronchitis were significantly associated with seroprevalence. Furthermore, a marginally significant relation with eczema was found. Immunoglobulin E specific for inhaled allergens occurred significantly more often in the Toxocara-seropositive group. The risk factors investigated were not related to seroprevalence. It is suggested that Toxocara, among other environmental factors, may stimulate polyclonally immunoglobulin E production, including allergen-specific immunoglobulin E, and thus may contribute to the manifestation of allergic asthma and possibly of eczema in children predisposed to allergy.

Animals↗

Prevalence of anti-Toxocara antibodies in a random sample of inpatients at a children's hospital in Vitória, Espírito Santo, Brazil.

In the streets of Vitória, in the State of Espírito Santo, Brazil, are large number of stray dogs, many of which are infected with Toxocara canis, suggesting a high risk for human infection. In order to investigate the prevalence of Toxocara infection in children in Espírito Santo we studied the prevalence of anti-Toxocara antibodies in 100 random inpatients over one year of age, at the Children's Hospital N.S. da Glória, the reference children's hospital for the State. All the sera were collected during the period between October 1996 and January 1997. The mean age was 6.6 +/- 4.1 yrs. (1 to 14 yrs., median 6 yrs.) and there were patients from all of the different wards of the hospital. Sixty-eight patients came from the metropolitan area of Vitória and the other 32 from 17 other municipalities. The anti-Toxocara antibodies were investigated by ELISA-IgG using a secretory-excretory antigen obtained from second stage larvae. All sera were adsorbed with Ascaris suum antigen before the test. Thirty-nine sera (39%) were positive, predominantly from boys, but the gender difference was not statistically significant (boys: 25/56 or 44.6%; girls: 14/44 or 31.8%; p = 0.311). The prevalence of positive sera was higher, but not statistically significant, in children from the urban periphery of metropolitan Vitória (formed by the cities of Vitória, Cariacica, Vila Velha, Serra and Viana) than in children from 17 other municipalities (44.1% and 28.1% respectively, p = 0.190). Although the samples studied do not represent all children living in the State of Espírito Santo, since the Children's Hospital N.S. da Glória admits only patients from the state health system, it is probable that these results indicate a high frequency of Toxocara infection in children living in Espírito Santo. Further studies of population samples are necessary to ascertain the prevalence of Toxocara infection in our country.

Adolescent↗

Prevalence of Toxocara infection in schoolchildren from the Butantã region, São Paulo, Brazil.

Visceral larva migrans syndrome by Toxocara affects mainly children between 2 and 5 years of age, it is generally asymptomatic, and the seroprevalence varies from 3 to 86% in different countries. A total of 399 schoolchildren from 14 public schools of the Butantã region, São Paulo city, Brazil, were evaluated by Toxocara serology (enzyme-linked immunosorbent assay). Epidemiological data to the Toxocara infection obtained from a protocol were submitted to multiple logistic regression analysis for a risk profile definition. Blood was collected on filter paper by finger puncture, with all samples tested in duplicate. Considering titers > or = 1/160 as positive, the seroprevalence obtained was 38.8%. Among infected children, the mean age was 9.4 years, with a similar distribution between genders. A significant association was observed with the presence of onychophagia, residence with a dirty backyard, living in a slum, previous wheezing episodes, school attended, and family income (p < 0.05). All data, except "living in a slum", were considered to be determinant of a risk profile for the acquisition of Toxocara infection. A monthly income > or = 5 minimum salaries represented a protective factor, although of low relevance. Toxocara eggs were found in at least one of the soil samples obtained from five schools, with high prevalence of Toxocara infections, indicating the frequent soil contamination by this agent.

Adolescent↗

Seroprevalence of Toxocara antibodies among patients suspected of ocular toxocariasis in Slovenia.

Ocular toxocariasis named also ocular larva migrans is caused by larvae of the roundworm Toxocara spp. The purpose of this study was to find out the seroprevalence of Toxocara antibodies in patients suspected of ocular toxocariasis. Between January 2001 and December 2003, sera from 239 ocular patients, aged 3 to 80 years, were examined by ELISA and confirmed by Western blot test. Out of the 239 patients, 172 (72%) were seronegative and 67 (28%) were Toxocara seropositive; 95% CI (22-34%). The median age of Toxocara seropositive patients was 37.6 years. There was no significant difference in the number of Toxocara positive sera between the younger age group (< or = 14 years) and the older age group (> 14 years), p > 0.05. A high rate of Toxocara seropositivity in ocular patients should alert the ophthalmologists in Slovenia to include toxocariasis in the differential diagnosis of eye diseases more frequently.

Adolescent↗

The high prevalence of asymptomatic Toxocara infection among schoolchildren in Manado, Indonesia.

We performed a serological survey of Toxocara canis infection in junior high school students from three districts in northern Sulawesi. Almost all of the 117 subjects from two rural districts near Manado allowed dogs in their houses, and there was an 84.6% prevalence of T. canis infection in this group. Fifty-three subjects (45.3%) had serum samples with a high titer of specific anti-Toxocara antibody. By contrast, 41 students tested in one urban district showed a 12.2% prevalence. To confirm the clinical symptoms of visceral larva migrans (VML) and ocular larva migrans (OLM) caused by Toxocara, we administered a questionnaire survey, serological liver function tests, and an ophthalmoscopic examination in 34 subjects having high anti-Toxocara antibodies. One rural district showed a high prevalence; 58 out of 71 subjects (81.7%) had a high titer of anti-Toxocara antibodies according to a plate-ELISA test, although none showed clinical signs. Five of these subjects exhibited hypereosinophilia. These results indicated that T. canis infection in northern Sulawesi is latent in many more cases than previously estimated, and suggest that people living in environments polluted by Toxocara eggs become easily infected with T. canis and show a high prevalence of infection.

Animals↗

[Vegetables for human consumption as probable source of Toxocara sp. infection in man].

Although Toxocara canis life cycle is known, other possible mechanisms dynamically involved in its transmission to man are still ignored. The object of the present investigation was to search the occurrence of Toxocara sp. eggs in vegetables which humans consume. Five hundred and thirty six vegetables from a supply distribution center in Mexico City (Distrito Federal) were examined. Those included 212 carrots, 76 potatoes, 31 radishes, 22 mushrooms, 27 lettuces, 20 sweet potatoes and 66 bundles of spinaches, 32 bundles of salt-worts, 29 bundles of coriander, and 21 bundles of purslane. Each unit or bundle was washed with 50 ml of sterilized water, allowing sedimentation at room temperature for 8 hours. Five ml of sediment were centrifugated at 3,000 r.p.m. for 5 minutes. Sediment was examined in lugol stained fresh plates through light microscopy, which turned to be Toxocara sp. eggs were found only in two vegetables: 1.9% of carrots and 6.5% of radishes. Toxocara sp. eggs were: 66.7% recently emitted and 33.3% embryonated. Other parasite elements were: Ascaris lumbricoides eggs 1.9% in carrots, 2.6% in potatoes, 9.1% in mushrooms, 6.9% in corianders, 20.0% in sweet potatoes and 6.1% in spinachs. Entamoeba histolytica cyts were found in 0.9% of carrots. Soil contamination with Toxocara sp. eggs from parasitized dogs or cats, or with either sewage systems or contaminated water where vegetables for human consumption are grown, play a role as a transmission mechanism must be deeperly studied since 33.3% of Toxocara sp. eggs found contained larvae, potentially infective to man.

Animals↗

Toxocara seroprevalence and childhood asthma among Malaysian children.

BACKGROUND: The larva of Toxocara spp., a common animal roundworm, may infect non-compatible hosts, causing a profound immunological reaction with marked eosinophil and IgE responses, not unlike in atopy. In this study, we determined the seroprevalence of Toxocara exposure in 66 asthmatic and 58 non-asthmatic children. METHODS: Exposure to Toxocara was determined by examining the serum samples of the children for specific IgG antibodies to L2 Toxocara larvae, using a commercially available diagnostic kit. RESULTS: There was no significant difference in the mean age, sex, social class, residence type and presence of domestic pets at home between the two children groups. Children with bronchial asthma were observed to have higher Toxocara seropositivity than that of the non-asthmatic controls (21.2 vs 8.6%, P=0.047). CONCLUSION: The observed relationship between exposure to Toxocara infection and bronchial asthma in Malaysian children warrants further evaluation. An understanding of any possible contribution to the pathogenesis of childhood asthma provides a potential avenue for prevention.

Asthma↗

Toxocara titres in maternal and cord blood.

Fifty-two pairs of maternal and cord blood samples were examined for evidence of Toxocara canis antibodies. All the mothers in the study delivered normal babies at term. Seventeen (33%) of the mothers had Toxocara antibody titres of 1:50 or greater. No IgM isotype anti-Toxocara antibody was detected in the cord blood samples, evidence that transplacental toxocaral infection had not occurred. In the toxocara antibody-positive group it was found that six of 17 mothers (35%) had previously miscarried compared with three of 35 (8.6%) of the toxocara-negative mothers (P = 0.044).

Adolescent↗

Toxocara infection is not associated with viral or bacterial central nervous system infection in children.

BACKGROUND: Helminth infections with larvae that migrate through the tissues have been considered risk factors for CNS infections. OBJECTIVES: The present work was designed to investigate the prevalence of anti- TOXOCARA antibodies in the serum and/or in the cerebrospinal fluid (CSF) of children with infectious meningitis or meningoencephalitis and of a control group, without meningitis, admitted at the Children's Hospital NS Glória, Vitória, ES, Brazil. PATIENTS AND METHODS: After adsorption with ASCARIS LUMBRICOIDES antigen, serum and/or cerebrospinal fluid of 381 inpatients (201 with meningitis and 180 without meningitis) were submitted to an ELISA IgG, for anti- TOXOCARA antibodies using secretion/excretion antigens of third stage larvae of T. CANIS. RESULTS: No significant differences between the meningitis and the control groups were observed in the frequencies of positive tests for anti- TOXOCARA antibodies in the serum or CSF (respectively for the meningitis and control group: 33/103 or 32 % and 52/152 or 34.2 % for the serum, p = 0.821; 48/184 or 26.1 % and 23/121 or 19.0 % for the CSF; p = 0.196. CONCLUSION: The results demonstrated that TOXOCARA infection, evaluated by detection of anti- TOXOCARA antibodies in serum or CSF, is not associated with viral or bacterial meningitis or meningoencephalitis in children in our country.

Animals↗

[Toxocara sp. eggs and Ancylostoma sp. larva in public parks, Brazil].

Visceral and cutaneous larva migrans are parasitic zoonoses caused by the infection of larval nematodes Toxocara sp. and Ancylostoma sp. respectively. The objective of this study was to investigate the contamination by Toxocara sp. eggs and Ancylostoma sp. eggs and larva of soil samples collected from public parks and children's playground areas in state of Minas Gerais, Brazil, using both Baermann's method and centrifugal flotation technique. Toxocara sp. and Ancylostoma sp. eggs were observed in soil samples collected from public squares in 17.4% (4/23) and 69.6 (16/23) respectively. In schools and child day care settings the contamination by Ancylostoma sp. larva in sand samples was 11.1% (2/18). Public parks are settings of more potential risk of Toxocara sp. eggs and Ancylostoma sp. infection. Stool parasitology testing of 174 stool samples showed 58% and 23% of Ancylostoma sp and Toxocara sp eggs infection respectively.

Ancylostoma↗