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Toxocaríase: confirmação laboratorial de casos clínicos suspeitos de infeção por Toxocara spp. entre 2018 e 2022
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Advisor(s)
Abstract(s)
A toxocaríase é uma infeção parasitária zoonótica com distribuição mundial,
considerada pelo Centre for Disease Control and Prevention (CDC) uma das
doenças parasitárias mais negligenciadas e que apresenta uma taxa de prevalência
subestimada, sendo raros os estudos sobre a seroprevalência para
Toxocara spp. em Portugal. A infeção no Homem pode ocorrer de várias formas,
sendo predominante a infeção através da ingestão de ovos infetados
existentes no meio ambiente.
O objetivo deste estudo foi efetuar uma análise dos resultados laboratoriais
de todos os casos com suspeita clínica de toxocaríase estudados no Laboratório
Nacional de Referência de Infeções Parasitárias e Fúngicas do Instituto
Nacional de Saúde Doutor Ricardo Jorge (INSA) entre 2018 e 2022, tal
como descrever as características demográficas dos casos confirmados.
As metodologias laboratoriais usadas foram métodos serológicos: determinação
qualitativa de anticorpos IgG para Toxocara canis – ELISA (TECAN)
e Imunoblot comercial (Ldbio Iberlab) para confirmação dos casos positivos.
Durante o período de estudo de 5 anos foram analisadas amostras de
soro de 542 casos suspeitos de infeção por Toxocara spp., dos quais 160
(29,5%) apresentaram serologia positiva, tendo 19% (30/160) ocorrido em
crianças entre os 5 e os 14 anos de idade, sendo este o grupo etário com
maior número de infeções causadas por este agente etiológico.
Estes resultados mostram uma seroprevalência muito superior aos 10,5%
encontrados na Região europeia sendo associada principalmente a fatores
socioeconómicos e ambientais, destacando-se a necessidade de uma compreensão
mais aprofundada da biologia molecular, bioquímica, genética,
epidemiologia e ecologia de Toxocara spp. que possam levar a novas e melhores
estratégias para o tratamento, diagnóstico e controlo desta parasitose,
tais como o desenvolvimento de uma vacina e/ou de um agente ovicida
eficaz, com vista a um melhor controlo deste problema de saúde pública.
Toxocar iasis is a zoonotic parasi tic infection wi th wor ldwide distr ibution, considered by the Center for Disease Control and Prevention to be one of the most neglected parasi tic diseases and which has an underestimated prevalence rate, wi th studies on seroprevalence for Toxocara spp being rare in Por tugal. It is a disease caused by the lar val forms of Toxocara spp., nematodes belonging to the order Ascar idiodea, fami ly Toxocar idae, wi th the species Toxocara canis, whose def ini tive hosts are canids, responsible for the major i ty of infections in humans. Infection in humans can occur in several ways, wi th the predominant mode of infection being through the ingestion of infected lar val eggs existing in the envi ronment, and presenting four main cl inical forms. The aim of the study was to per form an analysis of the laborator y resul ts of al l cases wi th cl inical suspicion of toxocar iasis studied at the Nat ional Reference Laborator y for Parasi t ic and Fungal Infect ions of the Nat ional Inst i tute of Heal th Dr Ricardo Jorge (Por tugal ) between 2018 and 2022, as descr ibe the demographic character ist ics in conf i rmed cases. The laborator y methodologies used were serological methods: qual i tative determination of IgG antibodies to Toxocara canis – ELISA (TECAN) and commercial Immunoblot (Ldbio Iber lab) to conf i rm posi tive cases. Dur ing the 5-year study per iod, serum samples f rom 542 suspected cases of Toxocara spp. infection were analyzed, of which 160 (29.5%) presented posi tive serology, 19% (30/160) of which occur red in chi ldren aged 5 and 14 years of age, this being the age group wi th the highest number of infections caused by this etiological agent. These results show a seroprevalence much higher than the 10.5% found in the European region, being associated mainly with socioeconomic and environmental factors, highlighting the need for a more in-depth understanding of the molecular biology, biochemistry, genetics, epidemiology and ecology of Toxocara spp. that could lead to new and bet ter strategies for treatment, diagnosis and control of this parasitic disease, such as the development of a vaccine and/or an ef fective ovicidal agent to control this helminthozoonosis and promote a higher public health standard.
Toxocar iasis is a zoonotic parasi tic infection wi th wor ldwide distr ibution, considered by the Center for Disease Control and Prevention to be one of the most neglected parasi tic diseases and which has an underestimated prevalence rate, wi th studies on seroprevalence for Toxocara spp being rare in Por tugal. It is a disease caused by the lar val forms of Toxocara spp., nematodes belonging to the order Ascar idiodea, fami ly Toxocar idae, wi th the species Toxocara canis, whose def ini tive hosts are canids, responsible for the major i ty of infections in humans. Infection in humans can occur in several ways, wi th the predominant mode of infection being through the ingestion of infected lar val eggs existing in the envi ronment, and presenting four main cl inical forms. The aim of the study was to per form an analysis of the laborator y resul ts of al l cases wi th cl inical suspicion of toxocar iasis studied at the Nat ional Reference Laborator y for Parasi t ic and Fungal Infect ions of the Nat ional Inst i tute of Heal th Dr Ricardo Jorge (Por tugal ) between 2018 and 2022, as descr ibe the demographic character ist ics in conf i rmed cases. The laborator y methodologies used were serological methods: qual i tative determination of IgG antibodies to Toxocara canis – ELISA (TECAN) and commercial Immunoblot (Ldbio Iber lab) to conf i rm posi tive cases. Dur ing the 5-year study per iod, serum samples f rom 542 suspected cases of Toxocara spp. infection were analyzed, of which 160 (29.5%) presented posi tive serology, 19% (30/160) of which occur red in chi ldren aged 5 and 14 years of age, this being the age group wi th the highest number of infections caused by this etiological agent. These results show a seroprevalence much higher than the 10.5% found in the European region, being associated mainly with socioeconomic and environmental factors, highlighting the need for a more in-depth understanding of the molecular biology, biochemistry, genetics, epidemiology and ecology of Toxocara spp. that could lead to new and bet ter strategies for treatment, diagnosis and control of this parasitic disease, such as the development of a vaccine and/or an ef fective ovicidal agent to control this helminthozoonosis and promote a higher public health standard.
Description
Keywords
Toxocaríase Infeção por Toxocara spp. Infeções Parasitárias Infeções Parasitárias Zoonóticas Infecções Sistémicas e Zoonoses Diagnóstico Laboratorial Doenças Infecciosas Portugal
Pedagogical Context
Citation
Boletim Epidemiológico Observações. 2024 janeiro-abril;13(35):30-35
Publisher
Instituto Nacional de Saúde Doutor Ricardo Jorge, IP