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Toxocariasis in North America: A Systematic Review
Open accessAbstract
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.
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The highest risk of Toxocara infection is in young children owing to an increased likelihood of high inoculum after ingestion of dog or cat feces containing ova.
“The highest risk is in young children owing to an increased likelihood of high inoculum after the ingestion of dog or cat feces containing ova. 26”
From Reducing the risk of pet-associated zoonotic infections (2015) · cites this paper as [26]
The Introduction (page unavailable) describes transmission through ingestion of eggs from canine or feline feces. The Results (page unavailable) identify age under 18 and exposure to feces-contaminated play areas as risk factors. The paper does not say young children have the highest risk because they are more likely to ingest a high inoculum. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe risk of Toxocara exposure is highest after contact with soil contaminated with waste from untreated or stray animals, such as in sandboxes, gardens, or playing fields.
“Because most household pets are regularly dewormed and larvae require two to three weeks after being passed in feces to become infective, the risk of exposure is highest after contact with soil contaminated with waste from untreated or stray animals, such as in sandboxes, gardens or playing fields. 2,26”
From Reducing the risk of pet-associated zoonotic infections (2015) · cites this paper as [26]
The Results (page unavailable) identify animal-feces contamination as an important risk factor and report higher risk for children playing in public areas with animal feces, including parks and sandboxes. They also say owned dogs are more likely to be dewormed than feral dogs. The paper does not establish that this is the highest-risk route, specifically identify gardens, or state the cited two-to-three-week interval before eggs become infective. (LLM, conf=0.84)
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Metadata
- Authors
- Lee, R. M., Moore, L. B., Bottazzi, M. E., & Hotez, P. J.
- Affiliations
- Baylor College of Medicine (US)
- Rice University (US)
- Corresponding author
- Hotez, Peter J.
- Venue
- PLoS Neglected Tropical Diseases
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-08-28
- Volume
- 8
- Issue
- 8
- Pages
- e3116
- ISSN
- 1935-2727 (ISSN-L)
- 1935-2735
- PMC
- PMC4148222
- OpenAlex
- W1990683804
- Cited by
- 122
- References
- 29
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 6 · 2023: 13 · 2022: 10 · 2021: 10 · 2020: 13 · 2019: 10 · 2018: 12 · 2017: 15 · 2016: 11 · 2015: 11 · 2014: 1
- FWCI
- 1.79
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS neglected tropical diseases (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Rice Research Repository (Rice University) (submittedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Parasitology › Parasitic infections in humans and animals
- Life Sciences › Immunology and Microbiology › Parasitology › Parasites and Host Interactions
- Health Sciences › Medicine › Infectious Diseases › Parasitic Diseases Research and Treatment
- Keywords
- toxocariasis, Toxocara, visceral larva migrans, ocular larva migrans, prevalence, incidence, disease burden, risk factors, pet ownership, poverty, asthma, waste pickers, psychiatric patients, North America
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Male, Middle Aged, North America, Risk Factors, Toxocariasis, Young Adult
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