Espinoza Yrma A, Huapaya Pedro E, Roldán William H, Jiménez Susana, Abanto Enma P, Rojas Carlos A, Cavero Yuri A, Gutiérrez César A
Instituto de Medicina Tropical Daniel A. Carrión, Universidad Nacional Mayor de San Marcos, Callao, Perú.
Rev Inst Med Trop Sao Paulo. 2010 Jan-Feb;52(1):31-6. doi: 10.1590/s0036-46652010000100005.
The aim of this study was to assess the seroprevalence of human toxocariasis in three Andean communities from the Northeast of Lima, Peru. A total of 303 subjects including children and adults were studied and blood samples were collected to detect anti-Toxocara antibodies by ELISA-IgG test and by hematological examination; stool samples were collected also for parasitological examination. The overall seroprevalence of toxocariasis observed in the total population was 20.46%, with a significant high proportion in children from one to 10 years old (p = 0.034). Among the subjects with positive serology, 32.26% of them had respiratory disturbances, 22.58% hepatomegaly, 17.74% ocular signs or symptoms, 14.51% abdominal pain, 9.68% neurological involvement, and 4.84% cutaneous signs, but none of these clinical features were associated to a positive serology by multivariate analysis. Furthermore, 79.03% of seropositive subjects also harbored at least one intestinal parasite, which was associated to a positive serology (p < 0.05). The presence of pets within the houses, a previous history of pica or geophagia and the use of public places were also present in this population, but only the latter was associated to the serology (p < 0.05). In conclusion, clinical, serological, and epidemiological evidences for larval Toxocara infection were found in the studied population.
本研究旨在评估秘鲁利马东北部三个安第斯社区人群的人体弓蛔虫病血清流行率。共对包括儿童和成人在内的303名受试者进行了研究,采集血样通过酶联免疫吸附试验(ELISA-IgG)检测抗弓蛔虫抗体,并进行血液学检查;同时采集粪便样本进行寄生虫学检查。在全部人群中观察到的弓蛔虫病总体血清流行率为20.46%,1至10岁儿童中的比例显著较高(p = 0.034)。在血清学检测呈阳性的受试者中,32.26%有呼吸功能紊乱,22.58%有肝肿大,17.74%有眼部体征或症状,14.51%有腹痛,9.68%有神经受累,4.84%有皮肤体征,但多因素分析显示这些临床特征均与血清学阳性无关。此外,79.03%的血清学阳性受试者还至少感染一种肠道寄生虫,这与血清学阳性相关(p < 0.05)。该人群中家庭内有宠物、既往有异食癖或食土癖病史以及使用公共场所等情况也存在,但只有后者与血清学相关(p < 0.05)。总之,在所研究人群中发现了幼虫型弓蛔虫感染的临床、血清学和流行病学证据。