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Toxocariasis in North America: A Systematic Review

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  • Rachel M Lee
  • Laura B Moore
  • Maria Elena Bottazzi
  • Peter J Hotez

Abstract

Toxocariasis is an important neglected tropical disease that can manifest as visceral or ocular larva migrans, or covert toxocariasis. All three forms pose a public health problem and cause significant morbidity in areas of high prevalence. To determine the burden of toxocariasis in North America, we conducted a systematic review of the literature following PRISMA guidelines. We found 18 articles with original prevalence, incidence, or case data for toxocariasis. Prevalence estimates ranged from 0.6% in a Canadian Inuit community to 30.8% in Mexican children with asthma. Commonly cited risk factors included: African-American race, poverty, male sex, and pet ownership or environmental contamination by animal feces. Increased prevalence of Toxocara spp. infection was linked in a group of case control studies conducted in Mexico to several high risk groups including waste pickers, asthmatic children, and inpatient psychiatry patients. Further research is needed to determine the true current burden of toxocariasis in North America; however the prevalence estimates gathered in this review suggest that the burden of disease is significant.Author Summary: Toxocariasis is a parasitic worm infection that is transmitted by the ingestion of parasite eggs present in the feces of dogs and cats. After ingestion of the Toxocara eggs, the released larvae migrate through human organs, including the lungs, liver, brain, and eyes, where they cause inflammation and organ damage. The different larval migrans syndromes associated with toxocariasis are diagnosed by detecting Toxocara antibodies in sera of infected individuals. This study is a systematic review to in order assess the prevalence of toxocariasis in North America and whether selected groups are at risk for infection. The prevalence was highest among Mexican children with asthma, but also African Americans living in poverty exhibited high rates of infection. Among the major risk factors for infection were African-American ethnicity, male sex, pet ownership, and environmental contamination by animal species. Additional high risk groups in Mexico included waste pickers, asthmatic children, and inpatient psychiatry patients. Further research is needed to determine the true current burden of toxocariasis in North America; however, the prevalence estimates gathered in this review suggest that the burden of disease is significant. Thus, toxocariasis may be emerging as an important health disparity in North America

Suggested Citation

  • Rachel M Lee & Laura B Moore & Maria Elena Bottazzi & Peter J Hotez, 2014. "Toxocariasis in North America: A Systematic Review," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 8(8), pages 1-7, August.
    • Handle: RePEc:plo:pntd00:0003116
    DOI: 10.1371/journal.pntd.0003116
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    References listed on IDEAS

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    1. Peter J Hotez, 2008. "Neglected Infections of Poverty in the United States of America," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 2(6), pages 1-11, June.
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