Toxocara eggs in public places worldwide - A systematic review and meta-analysis
Abstract
Toxocariasis is a neglected tropical disease of humans. Although many studies have indicated or shown that environmental contamination with Toxocara species eggs is a major risk factor for toxocariasis in humans, there has been no comprehensive analysis of published data or information. Here, we conducted the first systematic review and meta-analysis of current literature to assess the global prevalence of Toxocara eggs in public places (including beaches, parks and playgrounds). We conducted searches of the PubMed, Embase, Scopus and Science Direct databases for relevant studies published until 20 April 2018, and assessed the prevalence rates of Toxocara eggs in public places. We used the random effects model to calculate pooled prevalence estimates, with 95% confidence intervals (CIs), and analysed data in relation to WHO geographical regions. Subgroup analysis and meta-regressions regarding the geographical and environmental variables were also performed. Of 2384 publications identified, 109 studies that tested 42,797 soil samples in 40 countries were included in the meta-analysis. The pooled global prevalence of Toxocara eggs in public places was 21% (95% CI, 16-27%; 13,895/42,797). The estimated prevalence rates in the different WHO regions ranged from 13% to 35%: Western Pacific (35%; 95% CI, 15-58%), Africa (27%; 95% CI, 11-47%), South America (25%; 95% CI, 13-33%), South-East Asia (21%; 95% CI, 3-49%), Middle East and North Africa (18%; 95% CI, 11-24%), Europe (18%; 95% CI, 14-22%), and North and Central Americas (13%; 95% CI, 8-23%). A high prevalence was significantly associated with high geographical longitude (P = 0.04), low latitude (P = 0.02) and high relative environmental humidity (P = 0.04). This meta-analysis of data from published records indicates that public places are often heavily contaminated with eggs of Toxocara. This finding calls for measures to reduce the potential risk of infection and disease in humans.
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A recent meta-analysis of data from published records indicates that public places are often heavily contaminated with a pooled global prevalence of Toxocara eggs of 21%.
“A recent meta-analysis of data from published records indicates that public places are often heavily contaminated with a pooled global prevalence of Toxocara eggs of 21% [208].”
From A One Health Perspective on the Human-Companion Animal Relationship with Emphasis on Zoonotic Aspects. (2020) · cites this paper as [208]
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“A recent meta-analysis of data from published records indicates that public places are often heavily contaminated with a pooled global prevalence of Toxocara eggs of 21% [208].”
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“different WHO regions ranged from 13% to 35% (9).”
BackgroundThe Zoonotic Dog Roundworm Toxocara canis, a Worldwide Burden of Public Health
Waindok, P., Raulf, M., Springer, A., & Strube, C. (2020) · Parasitology research monographs · doi:10.1007/978-3-030-53230-7_2 · Cited by 6 · see citing works
Understanding the research and practical needs required to control toxocariasis in Iran
Ebrahimipour, M., Parsa, H., Kianifard, N., Nasibi, S., & Rostami, A. (2024) · Parasite Epidemiology and Control · doi:10.1016/j.parepi.2024.e00351 · Cited by 5 · see citing works
“The prevalence of Toxocara spp. eggs in public places of the country ranges from approximately 16% to 20% (Abbaszadeh Afshar et al., 2020; Fakhri et al., 2018; Maleki et al., 2018a).”
BackgroundInfluentialSelf-citationBhangale, G., Narladkar, B., & Tayde, R. S. (2021) · Veterinary Parasitology: Regional Studies and Reports · doi:10.1016/j.vprsr.2021.100560 · Cited by 5 · see citing works
Cheraghali, F., Jouybari, F. F., Tohidi, F., Ghasemikhah, R., Taghipour, A., & Sharbatkhori, M. (2021) · Comparative Immunology, Microbiology & Infectious Diseases · doi:10.1016/j.cimid.2021.101643 · Cited by 5
Shirvani, G., Abdizadeh, R., Naeini, K. M., Mortezaei, S., & Khaksar, M. (2019) · doi:10.15171/ijer.2019.31 · Cited by 5
Sun, T., Wang, R., Sun, Y.-N., Zhang, X.-X., Ge, C., & Li, Y. (2025) · Foods · doi:10.3390/foods14152599 · Cited by 4 · see citing works
“No publication bias is considered when the prevalence rate is obtained based on the ratio of positive sample size to total sample size [28,29].”
Modelling the risk of food-borne transmission of Toxocara spp. to humans
Healy, S. R., Morgan, E. R., Betson, M., & Prada, J. M. (2025) · Epidemiology and Infection · doi:10.1017/s0950268825000330 · Cited by 4
“The models also did not incorporate the risk of acquiring Toxocara spp. directly from the environment, which is a widely accepted transmission route to humans [6], and therefore do not compare risk from food with these other routes.”
Low intestinal parasite prevalence in Finnish pet dogs and cats
Rapp, P., Williamson, E.-M., Uski, R. E., Savikoski, I. E., Pynnönen, A., Gindonis, V., Sukura, A., & Näreaho, A. (2024) · Acta Veterinaria Scandinavica · doi:10.1186/s13028-024-00776-4 · Cited by 4 · see citing works
Rodrigues, D. C., da Cunha, C. N. D. O., Mattos, G. T., Martins, L. R., Nogueira, T., de Souza, M. D., de Avila, L. F. D. C., Ramos, D., & Scaini, C. J. (2024) · Parasitology Research · doi:10.1007/s00436-024-08272-4 · Cited by 4
“This neglected disease constitutes a major challenge for public health (Chen et al. 2018) because it is globally distributed and highly prevalent in developing countries (Fakhri et al. 2018).”
Toxocariasis in a Child with Autism Spectrum Disorder
Pieroni, F., Massei, F., Micheletti, M. V., Luti, L., Marco, E. D., Ludovisi, A., Casazza, G., & Bruschi, F. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18010283 · Cited by 4 · see citing works
“Toxocara canis and Toxocara cati are gastrointestinal parasites of canids and felids, respectively, with a ubiquitous worldwide distribution [1,2].”
BackgroundToxocara prevalence in dogs, cats and the environment in Russia.
Lukashev, A., Ruzina, M. N., & Akhmadishina, L. (2020) · Advances in Parasitology · doi:10.1016/bs.apar.2020.01.019 · Cited by 4
Trinh, Q. T., Tran, C. V., Trieu, A. T., Phạm, N. V., Pham, T. V., Nguyen, S., & Anh, D. N. (2025) · Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi · doi:10.1016/j.jmii.2025.12.002 · Cited by 3
Narkkul, U., Na-Ek, P., Pawestri, A., & Punsawad, C. (2025) · PLoS ONE · doi:10.1371/journal.pone.0320929 · Cited by 3
“%) was comparable with the 21% observed in southeastern Asia and the global pooled rate of 21% reported in a systematic review [56].”
Seroprevalence of Toxocara spp. in Pregnant Women: A Systematic Review and Meta-Analysis
Shayanfar, S., Bahadory, S., Taghipour, A., Foroutan, M., & Abdoli, A. (2024) · Infectious Diseases in Obstetrics and Gynecology · doi:10.1155/2024/1943353 · Cited by 3
“[4], which is a signi fi cant amount, and the prevalence in geographical areas, Western Paci fi c and the African region, has the highest values, and the high prevalence of toxocariasis in pregnant women in these geographical regions is not surprising.”
BackgroundOzone and peroxone disinfection of Toxocara canis eggs in water.
Ibáñez-Cervantes, G., Cruz-Bautista, J. D., Vargas-de-León, C., Rojas-Bernabé, A., Ramírez-Cortina, C. R., & Nogueda-Torres, B. (2024) · Tropical biomedicine · doi:10.47665/tb.41.1.006 · Cited by 3
“It is widely distributed worldwide and is estimated to infect tens of millions of people each year with an estimated seroprevalence of 19% (Fakhri et al ., 2018).”
BackgroundZheng, W.-B., Cai, L., Zou, Y., Gao, W.-W., Liu, Q., & Zhu, X.-Q. (2023) · Animals · doi:10.3390/ani13020299 · Cited by 3
“Adult Toxocara residing in the intestinal tract of a definitive host can excrete a large number of eggs, leading to a 21% prevalence of Toxocara eggs in soil samples in public places worldwide [7].”
BackgroundLung Lipidomic Alterations in Beagle Dogs Infected with Toxocara canis
Li, H.-Y., Zou, Y., Xu, Y., Cai, L., Xie, S.-C., Zhu, X.-Q., & Zheng, W.-B. (2022) · Animals · doi:10.3390/ani12223080 · Cited by 3
“canis can reside in the intestines of definitive hosts and excrete large numbers of eggs into the environment [3].”
BackgroundBazargan, N., Lari, A., Borhani, M., & Harandi, M. F. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.920182 · Cited by 3
Cai, L., Zou, Y., Xu, Y., Li, H.-Y., Xie, S.-C., Zhu, X.-Q., & Zheng, W.-B. (2022) · Animals · doi:10.3390/ani12121517 · Cited by 3
“canis by consuming food/water contaminated with infective eggs, and Toxocara eggs are very common in public places, with a prevalence of 21% [4,5].”
BackgroundMaia, F. D. S., Fonseca, A. D. O. D. S., Valente, J. D. S. S., Baptista, C. T., Moreira, Â. D. S., Botton, S. D. Á., Pötter, L., & Pereira, D. (2019) · Revista brasileira de parasitologia veterinaria = Brazilian journal of veterinary parasitology : Orgao Oficial do Colegio Brasileiro de Parasitologia Veterinaria · doi:10.1590/s1984-29612019007 · Cited by 3 · see citing works
Toxocariasis as an Emerging Public Health Challenge: An Update on One Health Future and Challenges
Sadr, S., & Borji, H. (2026) · IJID One Health · doi:10.1016/j.ijidoh.2026.100105 · Cited by 2
Rezapour, N., Hamedani, H. G., Sepidarkish, M., Kianifard, N., Nooshabadi, M. S., Parsa, H., Bagheri, K. H., Ebrahimi, M., Mohammadi, M., Tori, N. A., et al. (2025) · BMC Infectious Diseases · doi:10.1186/s12879-025-12410-3 · Cited by 2 · see citing works
“Consistent with prior meta-analysis studies on different aspects of toxocariasis [6, 20–22], T -seroprevalence in children varies significantly across geographical regions, with higher rates observed in resource-constrained settings.”
Self-citationKhan, A., Ahmad, S. J. N., Jafir, M., Ahmad, A., Irfan, M., Qasim, M., Ahmad, J. N., Sabir, M., Maqsood, M., Rehman, A., et al. (2025) · Journal of soil science and plant nutrition · doi:10.1007/s42729-025-02708-1 · Cited by 2
Zhou, Y.-J., Li, Z.-Y., Yu, Y., Xu, Z.-A., Zhu, X.-Q., & Zheng, W.-B. (2025) · BMC Genomics · doi:10.1186/s12864-025-12030-w · Cited by 2 · see citing works
“Furthermore, systematic analyses show Toxocara egg contamination in 7% of vegetables, 10% of cucurbits [8], and 21% of soil samples from public environments [9].”
Liravizadeh, S., AbdolahiKhabisi, S., Khorashad, A. S., & Mirahmadi, H. (2024) · Journal of Parasitology Research · doi:10.1155/2024/2132696 · Cited by 2
“The rate of soil contamination with Toxocara spp. eggs is a ff ected by sample collection, concentration method, soil type, cultural level, religious, behavioral patterns, temperature, humidity, and public health conditions [15, 16].”
BackgroundOh, Y.-H., Sohn, H., Choi, M., Hyun, M.-W., Hong, S., Lee, J.-S., Ryu, A., Kim, J.-H., & Shin, H.-J. (2023) · Healthcare · doi:10.3390/healthcare11212839 · Cited by 2 · see citing works
“Dogs and cats have apparently played crucial roles in spreading Toxocara spp. by shedding eggs, which are the definitive hosts of Toxocara canis and T. cati , respectively [9].”
BackgroundPourshahbazi, G., Khanahmad, H., Khadivi, R., Pestehchian, N., Yousefi, H., Abdizadeh, R., Mobarakeh, S., Boldaji, F., & Darani, H. Y. (2022) · Advanced Biomedical Research · doi:10.4103/abr.abr_36_22 · Cited by 2
“[20] Numerous studies have been performed so far about soil contamination with Toxocara eggs in different parts of the world[21] and in Iran.”
BackgroundINVESTIGATION OF ZOONOTIC HELMINTHS IN CHILDREN PLAYGROUNDS IN SIVAS PROVINCE
Erol, U., Altay, K., Şahin, Ö., & Urhan, O. F. (2021) · Etlik Veteriner Mikrobiyoloji Dergisi · doi:10.35864/evmd.999894 · Cited by 2 · see citing works
Kaneva, E. (2021) · Problems of infectious and parasitic diseases · doi:10.58395/pipd.v49i2.66 · Cited by 2
- Authors
- Fakhri, Y., Gasser, R. B., Rostami, A., Fan, C. K., Ghasemi, S. M., Javanian, M., Bayani, M., Armoon, B., & Moradi, B.
- Affiliations
- Shahid Beheshti University (IR)
- The University of Melbourne (AU)
- Babol University of Medical Sciences (IR)
- Taipei Medical University (TW)
- Saveh University of Medical Sciences (IR)
- Kermanshah University of Medical Sciences (IR)
- Corresponding author
- Rostami, A.
- Venue
- Environmental Pollution
- Publisher
- Elsevier BV
- Published
- 2018-11
- Volume
- 242
- Issue
- Pt B
- Pages
- 1467-1475
- ISSN
- 0269-7491 (ISSN-L)
- OpenAlex
- W2884340077
- Cited by
- 151
- References
- 0
- Citations by year
- 2026: 9 · 2025: 18 · 2024: 16 · 2023: 18 · 2022: 21 · 2021: 23 · 2020: 32 · 2019: 12 · 2018: 2
- FWCI
- 2.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Environmental Pollution (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Babol University of Medical Sciences (1397/5482)
- National Health and Medical Research Council of Australia
- Australian Research Council
- The University of Melbourne
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Parasitic infections in humans and animals
- Life Sciences › Immunology and Microbiology › Parasitology › Parasites and Host Interactions
- Health Sciences › Veterinary › Small Animals › Helminth infection and control
- Keywords
- Toxocara, toxocariasis, Toxocara eggs, environmental contamination, soil contamination, public places, beaches, parks, playgrounds, prevalence, neglected tropical diseases, geographic distribution, air humidity, WHO regions
- MeSH terms
- Animals, Environmental Microbiology, Environmental Monitoring, Parasite Egg Count, Soil, Soil Pollutants, Toxocara
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