Toxocara infection

  • 文章类型: Journal Article
    人类弓形虫病(HT)是全球范围内广泛存在的人畜共患传染病,特别是在热带地区流行。增强我们对弓形虫病的了解可以引起人们对这种被忽视的人畜共患病的社会经济影响和控制的更多关注。我们对有关伊朗弓形虫病的所有可用文章和官方文件进行了全面审查,以确定研究差距和控制其关键需求。这篇综述强调,尽管有许多研究探索了确定性和性腺宿主中弓形虫病的各个方面,以及人类和环境污染,该国不同地区仍然存在显著的数据缺陷和差距。这些差距涉及调查确定宿主的蠕虫负担和再感染率,开发更灵敏的方法来检测和区分弓形虫物种,并了解确定宿主动物的行为。此外,确定HT的潜在paratenic宿主并探索这些宿主中弓形虫幼虫的器官特异性亲和力和存活时间是探索的重要领域。还必须理解寄生虫在副科宿主中的sylvatic和domestic周期。此外,评估环境中的鸡蛋密度,探索潜在的新来源,如水,和确定具有弓形虫卵生存和发育的最佳气候条件的区域对于制定有效的预防和控制策略至关重要。确定风险群体,发展早期诊断技术,采用成像方法,识别人类的长期并发症也至关重要。社区卫生组织应优先对公众和专业人员进行健康教育。此外,准确估计确定的宿主种群,监视和防止他们在公共场所的活动,对宠物和流浪寄主实施定期驱虫做法,认识到感染作为健康优先事项的重要性至关重要。这种全面的理解倡导了一种整体的“一种健康”方法来控制HT。
    Human toxocariasis (HT) is a widespread zoonotic infection globally, notably prevalent in tropical areas. Enhancing our understanding of toxocariasis can lead to increased attention towards the socioeconomic impact and control of this neglected zoonosis. We conducted a comprehensive review of all available articles and official documents on toxocariasis in Iran to identify research gaps and critical needs for its control. This review highlights that despite numerous studies exploring various aspects of toxocariasis in definitive and paratenic hosts, as well as humans and environmental contamination, significant data deficiencies and gaps persist across different regions in the country. These gaps involve investigating the worm burden and reinfection rates in definitive hosts, developing more sensitive methods to detect and differentiate of Toxocara species, and understanding the behavior of definitive host animals. Additionally, identifying potential paratenic hosts for HT and exploring the organ-specific affinity and survival duration of Toxocara larvae within these hosts are essential areas for exploration. It\'s also imperative to comprehend the sylvatic and domestic cycles of the parasite in paratenic hosts. Furthermore, assessing egg density in the environment, exploring potential new sources such as water, and identifying regions with optimal climatic conditions for the survival and development of Toxocara eggs are crucial for the formulation of effective prevention and control strategies. Identifying at-risk groups, developing early diagnosis techniques, employing imaging methods, and identifying long-term complications in humans are also crucial. Community health organizations should prioritize health education for the public and professionals. Furthermore, accurately estimating definitive host populations, monitoring and preventing their movements in public places, implementing regular deworming practices for pets and stray hosts, and recognizing the infection\'s significance as a health priority are critical. This comprehensive understanding advocates for a holistic \"one health\" approach to control of HT.
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  • 文章类型: Journal Article
    目的:弓形虫病是一种人畜共患的寄生虫感染,具有重要的公共卫生考虑。该研究的目的是评估其主人转介给Karaj兽医诊所的家犬和猫中抗弓形虫物种抗体的患病率和相关风险因素,Alborz省,伊朗。
    方法:在2020年7月至12月之间进行了一项涉及540名狗和猫主人的横断面研究。通过直接访谈进行的问卷调查用于收集社会人口统计信息和相关风险因素的数据。收集血样并通过间接酶联免疫吸附测定(ELISA)进行测试。
    结果:540名参与者中弓形虫病的总体血清患病率为16.7%(540人中有90人)。当样本中的参与者按年龄分类时,10-29岁人群的弓形虫感染率高于其他人群(45.6%,41of90)。单因素分析显示,与土壤有接触的宠物主人[调整比值比(AOR)=7.61,95%CI:6.06-9.24,P=0.028],接触猫狗后洗手(AOR=2.42,95%CI:1.15-4.85,P=0.046),用生肉喂养宠物(AOR=11.01,95%CI:5.21-19.43,P=0.023)增加了患弓形虫病的风险。研究表明,人口统计学特征,如年龄,性别,居住地,教育,和宠物的栖息地与弓形虫病没有显着相关。
    结论:鉴于这些发现和弓形虫病对公共卫生的渐进影响及其在发展中国家的高患病率,包括伊朗,应采取措施向公众宣传人畜共患病,并消除其假定的传播。
    OBJECTIVE: Toxocariasis is a zoonotic parasitic infection with important public health considerations. The aim of the study was to assess the prevalence of anti-Toxocara species antibodies and associated risk factors in domestic dogs and cats referred by their owners to veterinary clinics located in Karaj, Alborz Province, Iran.
    METHODS: A cross-sectional study involving 540 owners of dogs and cats was conducted between July - December 2020. A questionnaire administered by direct interviews was used to collect socio-demographic information and data on associated risk factors. Blood samples were collected and tested by indirect enzyme-linked immunosorbent assay (ELISA).
    RESULTS: The overall sero-prevalence of toxocariasis among the 540 participants was 16.7% (90 of 540). When participants included in the sample were classified by age, those aged 10-29 years demonstrated higher Toxocara infection prevalence than other groups (45.6%, 41 of 90). Univariate analysis revealed that the pet owners who had contact with soil [adjusted odds ratio (AOR) = 7.61, 95% CI: 6.06-9.24, P = 0.028], practiced handwashing after contact with dogs and cats (AOR = 2.42, 95% CI: 1.15-4.85, P = 0.046), and feeding the pets with raw meat (AOR = 11.01, 95% CI: 5.21-19.43, P = 0.023) had an increased risk of acquiring toxocariasis. The study showed that demographic characteristics such as age, gender, place of residence, education, and pet\'s habitats were not significantly associated with toxocariasis.
    CONCLUSIONS: Given the findings and the progressive impact of toxocariasis in public health and its high prevalence in developing countries, including Iran, measures should be taken to inform the public about zoonoses and eliminate their putative transmission.
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  • 文章类型: Journal Article
    诊断多发性硬化症的关键步骤是排除异质性的多种多发性硬化症模拟物,这在强大的免疫调节剂治疗时代至关重要。在这次审查中,我们一般讨论弓形虫病的背景,目前中枢神经系统弓形虫感染是中东多发性硬化症的模拟之一,并分享我们对这种情况的诊断和管理的经验。这个实体在中东这样的地区似乎非常相关,在那里,人口流离失所和冲突可能导致不卫生的食物和水管理捆绑。应该接受诊断,尤其是在评估脊髓病患者时。脊髓中存在具有炎症特征的单个病变应提示血清学检查血清和脑脊液中的弓形虫IgG和IgM。这种感染是可以治疗的,大剂量阿苯达唑方案是最被接受的治疗方法之一。虽然大多数病例预后良好,一些患者有局部位于受影响的脊髓水平的残余缺陷。
    A critical step in the diagnosis of multiple sclerosis is to rule out a heterogeneous variety of multiple sclerosis mimickers, which is crucial in the era of powerful immune-modulator treatments. In this review, we discuss the background of toxocariasis in general, present central nervous system Toxocara infection as one of the multiple sclerosis mimickers in the Middle East, and share our experience about the diagnosis and management of this condition. This entity seems very relevant in a region such as the Middle East, where displacement of populations and conflict can result in non-hygienic food and water management bundles. The diagnosis should be entertained, especially when assessing patients with myelopathy. The presence of a single lesion in the spinal cord with inflammatory features should prompt serological testing for Toxocara IgG and IgM in serum and the cerebrospinal fluid. This infection is treatable, with the regimen of high-dose albendazole being one of the most accepted treatments. Although most cases exhibit a good prognosis, some have residual deficits localized to the affected spinal cord level.
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  • 文章类型: Journal Article
    背景:除了众所周知的危险因素,弓形虫感染被认为在儿童哮喘的发展中起着重要的病因作用。为了进一步探索这种联系,研究了伊朗北部哮喘儿童和健康对照者血清中弓形虫感染的患病率.
    方法:在本病例对照研究中,病例为145例根据全球哮喘倡议(GINA)指南诊断的经医生证实的哮喘儿童.对照组为115名年龄-性别-居住地匹配的儿童,他们没有医生诊断的哮喘。使用酶联免疫吸附测定法测试了抗Toxcara免疫球蛋白G(IgG)的存在。单变量和多变量逻辑回归方法用于病例对照比较。
    结果:哮喘儿童血清阳性率为4.1%(95%CI,3.4-4.7%),对照组为0.86%(95%CI,0.71-1.0%),提示强关联(P值<0.02)。此外,在患有中度持续性哮喘的儿童中,弓形虫感染并不明显更普遍(P值=0.12)(9.3%,3/32)比轻度持续性哮喘儿童(2.3%,3/113)。病例组中弓形虫感染儿童的总免疫球蛋白E(IgE)水平(222.3±367.1)明显高于未感染儿童(143.19±218.05)(P<0.05)。
    结论:我们的研究结果表明,弓形虫感染可能在儿童哮喘中发挥重要作用。需要进一步的实验和流行病学研究来澄清这一假设。
    BACKGROUND: Besides the well-known risk factors, Toxocara infection is thought to play a significant etiological role in the development of childhood asthma. To further explore this association, the prevalence of Toxocara infection in sera of asthmatic children and healthy controls in northern Iran was investigated.
    METHODS: In this case-control study, cases were 145 physician-confirmed asthmatic children diagnosed according to the Global Initiative for Asthma (GINA) guidelines. Controls were 115 age-sex-residence-matched children who did not have physician-diagnosed asthma. The presence of anti-Toxocara immunoglobulin G (IgG) was tested using enzyme-linked immunosorbent assay. Univariate and multivariate logistic regression methods were used for case-control comparisons.
    RESULTS: Seropositivity rate was 4.1% (95% CI, 3.4-4.7%) in asthmatic children and 0.86% (95% CI, 0.71-1.0%) in controls, suggesting a strong association (P-value < 0.02). Moreover, Toxocara infection was not significantly more prevalent (P-value = 0.12) in children with moderate sustainable asthma (9.3%, 3/32) than in children with mild sustainable asthma (2.3%, 3/113). Mean total immunoglobulin E (IgE) level was significantly higher in Toxocara-infected children (222.3 ± 367.1) than in non-infected children (143.19 ± 218.05) in the case group (P-value < 0.05).
    CONCLUSIONS: Our findings indicated that Toxocara infection can play an important role in childhood asthma. Further experimental and epidemiological studies are needed to clarify this hypothesis.
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  • 文章类型: Journal Article
    Zoonotic parasites, including Toxocara species, of pet and stray cats are of public health importance. Justification for, and the design and implementation of prevention and control of human toxocariasis may benefit from an understanding of the zoonotic potential and prevalence of parasites in this definitive host species. This is the first systematic review and meta-analysis of cross-sectional studies, conducted to estimate the prevalence of Toxocara infection(s) in cats by geographical location, type (rural vs urban and stray vs pet), gender and age. Pooled data were assessed using a random effects-model as well as several meta-regression and stratified analyses conducted. Of 1733 peer-reviewed articles, 143 were included in this review and represented 2,158,069 cats from 51 countries. The global pooled (95% CI) prevalence of Toxocara infection in cats was 17.0% (16.1-17.8%), being highest in African (43.3%, 28.3-58.4%) and lowest in South American (12.6%, 8.2-17.0%) countries. In other WHO regions, prevalence rates of Toxocara were as follows: Eastern Mediterranean (21.6%, 15.1-28.1%), North America (18.3%, 15.4-21.2%), Europe (17.8%, 15.9-19.7%), Western Pacific (17.3%, 14.7-19.9%), and South-East Asia (14.9%, 9.8-20.1%). Prevalence of Toxocara was higher in low-income tropical countries and also in stray (28.6%, 25.1-32.1%) and young (≤12 months of age) (27.7%, 23.4-32.0%) cats than in pet (11.6%, 10.7-12.5%) and older cats (>12 months of age) (23.8%, 14.8-32.7%). This review indicates that ~118-150 million cats worldwide serve as definitive hosts of Toxocara, shedding eggs and thus contributing to the public health risk of human infection. Prevention and control of this zoonosis in cats should receive greater attention by health officials and cat owners, particularly in countries where risk factors and prevalence are highest.
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  • 文章类型: Journal Article
    狗是犬弓形虫最重要的确定宿主,弓形虫是人类弓形虫病的病原体,也是世界上最普遍的人畜共患蠕虫之一。进行本研究以评估犬T.canis感染的全球患病率。PubMed,Scopus,WebofScience,搜索EMBASE和SciELO以确定相关研究。使用随机效应模型来估计整个研究的总体和亚组合并患病率,异质性通过I2检验进行评估。数据根据世卫组织区域进行分类,不同类型的狗,风险因素和环境变量。在总共4370份同行评审的出版物中,研究了60个国家的13,010,004只狗的229篇文章符合最终纳入标准。犬弓形虫感染的总体患病率为11.1%(95%CI,10.6-11.7%)。世卫组织不同区域的估计患病率从6.4%到19.2%不等:东地中海(19.2%,13.7-25.5%),非洲(18.5%,13.7-23.9%),东南亚(11.9%,6.8-18.2%),北美(11.1%,10.6-11.7%),南美洲(10.9%,7.6-14.6%),欧洲(10.8%,8.9-12.9%)和西太平洋(6.4%,3.3-10.2%)。年轻(<1岁),流浪,农村犬和雄性犬的感染率明显高于老年犬(P<0.001),宠物,城市或雌性狗。低地理纬度的低收入国家和地区的患病率较高,靠近赤道,具有热带气候的特点。从这篇评论来看,据估计,全世界有超过1亿只狗感染了弓形虫。这凸显了需要更加重视实施负担得起的,适当的控制计划,以减少弓形虫病作为全球重要的人畜共患病的公共卫生威胁。
    Dogs serve as the most important definitive hosts for Toxocara canis-a causative agent of human toxocariasis and one of the most widespread zoonotic helminth worldwide. The present study was undertaken to assess the global prevalence of T. canis infection in dogs. PubMed, Scopus, Web of Science, EMBASE and SciELO were searched to identify relevant studies. A random-effects model was used to estimate the overall and the subgroup-pooled prevalences across studies, and heterogeneity was assessed via the I2 test. The data were categorized according to WHO-region, different types of dogs, risk factors and environmental variables. From a total of 4370 peer-reviewed publications, 229 articles that studied 13,010,004 dogs in 60 countries met the final inclusion criteria. The overall prevalence of Toxocara infection in dogs was 11.1% (95% CI, 10.6-11.7%). The estimated prevalence in the different WHO-regions ranged from 6.4% to 19.2%: Eastern Mediterranean (19.2%, 13.7-25.5%), Africa (18.5%, 13.7-23.9%), South-East Asia (11.9%, 6.8-18.2%), North America (11.1%, 10.6-11.7%), South America (10.9%, 7.6-14.6%), Europe (10.8%, 8.9-12.9%) and Western Pacific (6.4%, 3.3-10.2%). Young (<1 year of age), stray, rural and male dogs had a significantly (P<0.001) higher prevalence of infection than older, pet, urban or female dogs. The prevalence was higher in low income countries and regions at a low geographical latitude, close to the equator, characterized as having tropical climates. From this review, it is estimated that ≥100 million dogs are infected with Toxocara around the world. This highlights the need for an increased focus on implementing affordable, appropriate control programs to reduce the public health threat of toxocariasis as a zoonosis of global importance.
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  • 文章类型: Journal Article
    目的:本研究旨在标准化“室内”免疫测定法,以检测人血清中的抗弓形虫IgG抗体,以评估弓形虫感染的血清阳性率。并确定生活在萨尔瓦多贫困地区的儿童的潜在危险因素,巴西东北部的一个大城市。
    方法:1309名儿童的父母回答了一份包含感染可能危险因素的问卷。收集血液,并通过间接ELISA检测抗弓形虫IgG抗体的存在,该间接ELISA使用先前用A虫抗原吸收的血清中的犬幼虫排泄分泌抗原。
    结果:弓形虫感染的血清阳性率为48.4%。儿童的年龄,低母亲教育,与猫和狗接触,和位于铺好的街道上的家庭被证明是弓形虫感染的危险因素。
    结论:生活在巴西贫困城市环境中的儿童中,弓形虫感染的血清阳性率很高。低母亲教育与高弓形虫感染的关联支持研究表明,低社会经济地位是获得这种感染的危险因素,这反映了家庭的卫生习惯。在这个儿童群体中,被感染的狗和猫都可能参与这种寄生虫的传播。
    OBJECTIVE: This study aimed to standardize an \"in house\" immunoassay to detect anti-Toxocara IgG antibodies in human serum to estimate the seroprevalence of Toxocara infection, and to identify its potential risk factors in children living in poor areas of Salvador, a large northeastern Brazilian city.
    METHODS: Parents of 1309 children answered a questionnaire containing possible risk factor for acquisition of this infection. Blood was collected and the presence of anti-Toxocara IgG antibodies was detected by indirect ELISA using T. canis larval excretory-secretory antigens in sera previously absorbed with Ascaris lumbricoides antigens.
    RESULTS: Seroprevalence of Toxocara infection was 48.4%. Children\'s age, low maternal schooling, contact with dogs and cats, and household located in paved streets were shown to be risk factors for Toxocara infection.
    CONCLUSIONS: The seroprevalence of Toxocara infection is high among children living in a poor urban setting of Brazil. The association of low maternal education with higher Toxocara infection supports studies showing that low socioeconomic status is a risk factor for the acquisition of this infection as a reflection of hygiene habits of the family. And both infected-dogs and cats may be involved in this parasite transmission in this children population.
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