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Acta Parasitologica Sep 2020Toxocariasis is one of the neglected zoonosis with considerable public health importance around the world. The current study aimed to elucidate the overall prevalence of... (Meta-Analysis)
Meta-Analysis
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.
Topics: Animals; Cat Diseases; Cats; Dog Diseases; Dogs; Humans; Incidence; Iran; Prevalence; Public Health; Toxocara; Toxocariasis; Zoonoses
PubMed: 32319035
DOI: 10.2478/s11686-020-00195-1 -
The Cochrane Database of Systematic... Jun 2022It is estimated that 1.5 billion people are infected with soil-transmitted helminths (STHs) worldwide. Re-infection occurs rapidly following deworming, and interruption... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
It is estimated that 1.5 billion people are infected with soil-transmitted helminths (STHs) worldwide. Re-infection occurs rapidly following deworming, and interruption of transmission is unlikely without complementary control efforts such as improvements in water, sanitation, and hygiene (WASH) access and behaviours.
OBJECTIVES
To assess the effectiveness of WASH interventions to prevent STH infection.
SEARCH METHODS
We used standard, extensive Cochrane search methods. The latest search date was 19 October 2021.
SELECTION CRITERIA
We included interventions to improve WASH access or practices in communities where STHs are endemic. We included randomized controlled trials (RCTs), as well as trials with an external control group where participants (or clusters) were allocated to different interventions using a non-random method (non-RCTs). We did not include observational study designs. Our primary outcome was prevalence of any STH infection. Prevalence of individual worms was a secondary outcome, including for Ascaris lumbricoides, Trichuris trichiura, hookworm (Ancylostoma duodenale or Necator americanus), or Strongyloides stercoralis. Intensity of infection, measured as a count of eggs per gram of faeces for each species, was another secondary outcome.
DATA COLLECTION AND ANALYSIS
Two review authors independently reviewed titles and abstracts and full-text records for eligibility, performed data extraction, and assessed risk of bias using the Cochrane risk of bias assessment tool for RCTs and the EPOC tool for non-RCTs. We used a random-effects meta-analysis to pool study estimates. We used Moran's I² statistic to assess heterogeneity and conducted subgroup analyses to explore sources of heterogeneity. We assessed the certainty of the evidence using the GRADE approach.
MAIN RESULTS
We included 32 studies (16 RCTs and 16 non-RCTs) involving a total of 52,944 participants in the review. Twenty-two studies (14 RCTs (16 estimates) and eight non-RCTs (11 estimates)) reported on our primary outcome, prevalence of infection with at least one STH species. Twenty-one studies reported on the prevalence of A lumbricoides (12 RCTs and 9 non-RCTs); 17 on the prevalence of T trichiura (9 RCTs and 8 non-RCTs); 18 on the prevalence of hookworm (10 RCTs and 8 non-RCTs); and one on the prevalence of S stercoralis (1 non-RCT). Sixteen studies measured the intensity of infection for an individual STH type. Ten RCTs and five non-RCTs reported on the intensity of infection of A lumbricoides; eight RCTs and five non-RCTs measured the intensity of infection of T trichiura; and eight RCTs and five non-RCTs measured the intensity of hookworm infection. No studies reported on the intensity of infection of S stercoralis. The overall pooled effect estimates showed that the WASH interventions under study may result in a slight reduction of any STH infection, with an odds ratio (OR) of 0.86 amongst RCTs (95% confidence interval (CI) 0.74 to 1.01; moderate-certainty evidence) and an OR of 0.71 amongst non-RCTs (95% CI 0.54 to 0.94; low-certainty evidence). All six of the meta-analyses assessing individual worm infection amongst both RCTs and non-RCTs had pooled estimates in the preventive direction, although all CIs encapsulated the null, leaving the possibility of the null or even harmful effects; the certainty of the evidence ranged from very low to moderate. Individual studies assessing intensity of infection showed mixed evidence supporting WASH. Subgroup analyses focusing on narrow specific subsets of water, sanitation, and hygiene interventions did very little to elucidate which interventions might be better than others. Data on intensity of infection (e.g. faecal egg count) were reported in a variety of ways across studies, precluding the pooling of results for this outcome. We did not find any studies reporting adverse events resulting from the WASH interventions under study or from mass drug administration (MDA).
AUTHORS' CONCLUSIONS
Whilst the available evidence suggests that the WASH interventions under study may slightly protect against STH infection, WASH also serves as a broad preventive measure for many other diseases that have a faecal oral transmission route of transmission. As many of the studies were done in addition to MDA/deworming (i.e. MDA was ongoing in both the intervention and control arm), our data support WHO recommendations for implementation of improvements to basic sanitation and adequate access to safe water alongside MDA. The biological plausibility for improved access to WASH to interrupt transmission of STHs is clear, but WASH interventions as currently delivered have shown impacts that were lower than expected. There is a need for more rigorous and targeted implementation research and process evaluations in order that future WASH interventions can better provide benefit to users. Inconsistent reporting of the intensity of infection underscores the need to define the minimal, standard data that should be collected globally on STHs to enable pooled analyses and comparisons.
Topics: Animals; Ascaris lumbricoides; Humans; Hygiene; Observational Studies as Topic; Sanitation; Soil; Water
PubMed: 35726112
DOI: 10.1002/14651858.CD012199.pub2 -
Advances in Parasitology 2020Dogs 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.... (Meta-Analysis)
Meta-Analysis
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 I 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.
Topics: Animals; Dog Diseases; Dogs; Prevalence; Risk Factors; Toxocara canis; Toxocariasis
PubMed: 32381218
DOI: 10.1016/bs.apar.2020.01.017 -
Frontiers in Public Health 2024According to the Global Burden of Disease (GBD) 2019 report, up to 1.5 million disability-adjusted life years (DALYs) are lost due to soil-transmitted helminths (STHs),... (Meta-Analysis)
Meta-Analysis
BACKGROUND
According to the Global Burden of Disease (GBD) 2019 report, up to 1.5 million disability-adjusted life years (DALYs) are lost due to soil-transmitted helminths (STHs), and 5.9 million people are at risk of acquiring STHs. Regions with the highest prevalence of STH infections include Sub-Saharan Africa, China, South America, and Asia. While there are numerous fragmented studies on STH, comprehensive information on the prevalence and geographic distribution of different species, as well as their regional variations in the context of STHs is limited. The present systematic review and meta-analysis study attempts to provide a summary of the prevalence, geographical variation, and determinants of STHs among schoolchildren aged 5 to 18 years.
METHODS
An extensive literature search was carried out using PubMed, Embase, Cinhal, and Psychinfo for studies published between 1999 and 2022 that reported the rate of STH infection in school-going children aged 5-18 years. A random effects model was employed in this meta-analysis due to expected heterogeneity. Subgroup analysis was carried out based on sex and STH species because of expected geographical variation.
RESULTS
A total of 19,725 of the 49,630 children examined were infected with STH, yielding an overall pooled prevalence of 37.16% (95% CI: 29.74-44.89). The prevalence was highest in the Western Pacific region at 50.41% (95% CI: 33.74-67.04) followed by Europe at 39.74% (95% CI: 20.40-61.0) and Africa at 37.10% (95% CI: 26.84-47.95). was found to be the most prevalent helminth with a prevalence of 24.07% (95% CI: 17.07-31.83).
CONCLUSION
The Western Pacific region is classified as a High-risk Zone (HRZ), while Southeast Asia, Africa, Europe, and the Eastern Mediterranean are classified as moderate-risk zones (MRZs). We found a 12% reduction in the pooled prevalence of STH infection from 1999 to 2012. was the predominant species among schoolchildren. Mass Drug Administration (MDA) of Albendazole tablets and improved water, sanitation, and hygiene (WASH) practices are effective in controlling and preventing STH. Ensuring their implementation and access is crucial to addressing the problem.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/#loginpage, CRD42022333341.
Topics: Animals; Child; Humans; Ascaris lumbricoides; Developing Countries; Helminthiasis; Helminths; Prevalence; Soil; Child, Preschool; Adolescent
PubMed: 38577281
DOI: 10.3389/fpubh.2024.1283054 -
Transactions of the Royal Society of... Jul 2022Toxocariasis 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,...
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.
Topics: Animals; Anthelmintics; Eosinophilia; Humans; Neglected Diseases; Toxocara; Toxocara canis; Toxocariasis
PubMed: 34791477
DOI: 10.1093/trstmh/trab177 -
BMC Infectious Diseases Jul 2020Tuberculosis and intestinal parasites are mostly affecting poor people. They are in a vicious since one is the risk factor for the other. However, the comprehensive... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Tuberculosis and intestinal parasites are mostly affecting poor people. They are in a vicious since one is the risk factor for the other. However, the comprehensive report on the burden and co-incidence of intestinal parasites and tuberculosis in Ethiopia is scant. This systematic review and meta-analysis aimed to provide abridge conclusive evidence on the intestinal parasite-tuberculosis co-infection in Ethiopia.
METHODS
A total of 414 articles published in English were searched from both electronic databases (CINAHL, DOAJ, Embase, Emcare, Medline, ProQuest, and PubMed, Science Direct, and Web of Science) and other sources. The qualities of the included studies were assessed using the Joanna Briggs Institute Critical Appraisal tools and the publication bias was measured using the funnel plot and Eggers regression test. Comprehensive meta-analysis (CMA) Version 3.3.07 and Review Manager software were used to estimate pooled prevalence and associations of intestinal parasites and tuberculosis infection.
RESULTS
Eleven articles with a total of 3158 tuberculosis patients included in the analysis based on the eligibility criteria. The estimated pooled prevalence of intestinal parasites co-infection was 33% (95% CI: 23.3, 44.3) using the random-effects model. The most common intestinal parasites were Ascaris lumbricoides 10.5% (95% CI: 6.0, 17.5), Hookworm 9.5% (95% CI: 6.10, 14.4), Giardia lamblia 5.7% (95% CI: 2.90, 10.9) and Strongyloides sterocoralis 5.6% (95% CI: 3.3, 9.5). The odds of intestinal parasites infection was higher among tuberculosis patients compared to tuberculosis free individuals (OR = 1.76; 95% CI: 1.17, 2.63). A significant difference was observed among TB patients for infection with intestinal helminths (OR = 2.01; 95% CI: 1.07, 3.80) but not for intestinal protozoans when compared with their counterparts. The odds of multiple parasitic infections was higher among tuberculosis patients (OR = 2.59, 95% CI: 1.90, 3.55) compared to tuberculosis free individuals. However, intestinal parasites co-infection was not associated with HIV status among tuberculosis patients (OR = 0.97; 95% CI: 0.71, 1.32).
CONCLUSION
One-third of tuberculosis patients are co-infected with one or more intestinal parasites, and they are more likely to be infected with intestinal helminths and multiple intestinal parasitic infections compared to TB free individuals. We recommend routine screening of tuberculosis patients for intestinal parasites. The effect of mass deworming on tuberculosis incidence would be important to be considered in future researches.
TRIAL REGISTRATION
Registered on PROSPERO with reference number ID: CRD42019135350 .
Topics: Ancylostomatoidea; Animals; Ascaris lumbricoides; Coinfection; Ethiopia; Feces; Female; Giardia lamblia; Humans; Intestinal Diseases, Parasitic; Male; Prevalence; Risk Factors; Tuberculosis
PubMed: 32664873
DOI: 10.1186/s12879-020-05237-7 -
Infectious Diseases in Obstetrics and... 2024Toxocariasis is an important health problem caused by the parasitic species () and (). Prevalence of toxocariasis in pregnant women as a vulnerable population is... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Toxocariasis is an important health problem caused by the parasitic species () and (). Prevalence of toxocariasis in pregnant women as a vulnerable population is doubly important, and the aim of this study is to estimate the overall prevalence of toxocariasis infection in pregnant women according to the available reports.
METHODS
The present study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklists. A systematic search was carried out in international scientific databases (Google Scholar, Web of Science, ScienceDirect, Scopus, and PubMed) between 1990 and 2023. The overall prevalence of parasitic infection was estimated with a random-effects model. All analyses (overall prevalence, heterogeneity, publication bias, and sensitivity analysis) were performed with comprehensive meta-analysis (V2.2, Bio stat) software.
RESULTS
Amid the final eleven included studies, based on the random-effects model, the estimation of the pooled prevalence of spp. was 20.8% (95% CI, 9.8-38.7%). The association between the risk factors of toxocariasis and the prevalence of the disease was not statistically significant.
CONCLUSIONS
In the present study, significant prevalence was reported; however, considering the limited number of studies, it seems that the actual prevalence of the disease is higher. Therefore, it seems necessary to monitor this health problem in pregnant women.
Topics: Humans; Female; Pregnancy; Toxocariasis; Animals; Toxocara; Seroepidemiologic Studies; Pregnancy Complications, Parasitic; Prevalence; Toxocara canis
PubMed: 38682081
DOI: 10.1155/2024/1943353 -
BMC Infectious Diseases Jan 2020Toxocariasis 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... (Meta-Analysis)
Meta-Analysis
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.
Topics: Adolescent; Adult; Animals; Cats; Child; Child, Preschool; Dogs; Feces; Foxes; Host-Parasite Interactions; Humans; Infant; Iran; Jackals; Prevalence; Risk Factors; Seroepidemiologic Studies; Toxascaris; Toxocara canis; Toxocariasis; Young Adult
PubMed: 31910815
DOI: 10.1186/s12879-020-4759-8 -
Advances in Parasitology 2020Toxocariasis is a neglected parasitic zoonosis. Although some studies have reported the Toxocara prevalence in dogs and cats in mainland China, there is a lack of...
Toxocariasis is a neglected parasitic zoonosis. Although some studies have reported the Toxocara prevalence in dogs and cats in mainland China, there is a lack of comprehensive analysis of these data. Here, we conducted the first systematic review based on relevant literatures published in Web of Science, PubMed and CNKI from January 2000 to July 2019 to assess the prevalence of Toxocara infection in dogs and cats in mainland China. A total of 68 eligible papers were retrieved, including 24,490 dogs and 844 cats, with 17.34% (4246/24,490) Toxocara canis prevalence in dogs and 22.04% (186/844) Toxocara cati prevalence in cats by faecal floatation method. The prevalence and risk factors of T. canis and T. cati infection in different geographical regions, years, breeds, ages and genders were estimated in this review. This review indicates that there was high prevalence of Toxocara infection in dogs and cats in China. This finding calls for measures to reduce the potential risk of Toxocara infection and toxocariasis in humans and animals.
Topics: Animals; Cats; China; Dogs; Prevalence; Risk Factors; Toxocara; Toxocara canis; Toxocariasis
PubMed: 32381229
DOI: 10.1016/bs.apar.2020.01.031 -
Veterinary Parasitology, Regional... Apr 2021Parasitic zoonoses despite of their potential threats to human health remain neglected especially in developing countries. Toxocara canis and Toxocara cati worms are... (Meta-Analysis)
Meta-Analysis
Parasitic zoonoses despite of their potential threats to human health remain neglected especially in developing countries. Toxocara canis and Toxocara cati worms are considered important zoonotic parasites and the ability of their infective ova to sustain longer in suitable edaphic environments poses constant risk of infection to humans. This systematic review and meta-analysis aims to highlight the burden and importance of soil borne toxocariasis in India. A total of 14 primary prevalence studies spanned over a period from 1985 to 2017 were included in this study. Due to expected variation between studies, a random-effects model was applied by using MetaXL add-on. The apparent prevalence based on the soil samples tested positive was found in the range of 2.11 to 31.0% while the weighted pooled prevalence was estimated as 11.26 (95% CI 07.59 - 15.54%). A high heterogeneity between studies (I = 93.39 and Q = 227.024, p = 0.00) confirmed the diversity of the populations under study. This meta-analysis highlights the need of more studies on soil transmission of zoonotic toxocariasis in India.
Topics: Animals; Soil; Toxocara; Toxocara canis; Toxocariasis; Zoonoses
PubMed: 34024376
DOI: 10.1016/j.vprsr.2021.100560