1. Seroprevalence estimates for toxocariasis in people worldwide: A systematic review and meta-analysis.
- Author
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Rostami, Ali, Riahi, Seyed Mohammad, Holland, Celia V., Taghipour, Ali, Khalili-Fomeshi, Mohsen, Fakhri, Yadolah, Omrani, Vahid Fallah, Hotez, Peter J., and Gasser, Robin B.
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META-analysis ,SEROPREVALENCE ,RANDOM effects model ,POPULATION ,HUMAN Development Index - Abstract
Background: Human toxocariasis is an important neglected disease. We performed a systematic review and meta-analysis study to estimate the global and regional prevalence of anti-Toxocara serum antibodies (referred to as 'T-seroprevalence') in human populations around the world. Methods: We searched five international databases (PubMed, EMBASE, Web of Science, SciELO and Scopus) for seroprevalence studies published from 1 January 1980 to 15 March 2019. We used random effect models to calculate the overall T-seroprevalence (with 95% CIs) in all six WHO regions and worldwide. We also conducted subgroup and linear meta-regression analyses to evaluate the impact of socio-demographic, geographical and climatic parameters on seroprevalence. Results: We identified 250 eligible studies (253 datasets) comprising 265,327 participants in 71 countries for inclusion in the present meta-analysis. The estimated global T-seroprevalence rate was 19.0% (95%CI, 16.6–21.4%; 62,927/265,327); seroprevalence was highest in the African region (37.7%; 25.7–50.6%) and lowest in the Eastern Mediterranean region (8.2%; 5.1–12.0%). The pooled seroprevalence for other WHO regions was 34.1% (20.2–49.4%) in the South-East Asia; 24.2% (16.0–33.5%) in the Western Pacific; 22.8% (19.7–26.0%) in the American; and 10.5% (8.5–12.8%) in the European regions. A significantly higher T-seroprevalence was associated with a lower income level; lower human development index (HDI); lower latitude; higher humidity; higher temperature; and higher precipitation (P-value < 0.001). Potential risk factors associated with seropositivity to Toxocara included male gender; living in a rural area; young age; close contact with dogs, cats or soil; consumption of raw meat; and the drinking of untreated water. Conclusions: The present findings indicate high levels of infection with, or exposure to Toxocara spp. in many countries, which calls for increased attention to human toxocariasis and improved measures to prevent adverse health risks of this disease. Author summary: There have been many epidemiological studies on the seroprevalence of Toxocara infection or toxocariasis in humans in individual countries, but there has been no systematic review/meta-analysis to estimate the extent of Toxocara infection or exposure in human populations worldwide. By reviewing 250 studies of 265,327 people from 71 countries, we provide the first comprehensive global estimates of T-seroprevalence in humans to date. The findings indicate that almost one fifth (19%) of the world's human population is seropositive to Toxocara. The highest seroprevalence rates were found in Africa (37.7%) and the lowest in the Eastern Mediterranean region (8.2%). Individual countries with high HDIs and high income levels usually had low T-seroprevalence rates. Our findings also showed that T-seroprevalence varies markedly among countries, according to geographical location (coordinates) and climatic features. Evidence from this study indicates that human toxocariasis is a prevalent, neglected tropical disease and potentially one of major importance to global public health. Our study emphasizes the need for governmental authorities to pay increased attention to the risks and socioeconomic impact of HT in many countries around the world, and for them to design and implement HT prevention or control programs, considering risk predictors identified here. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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