Services on Demand
On-line version ISSN 1678-9946
Rev. Inst. Med. trop. S. Paulo vol.45 no.5 São Paulo Sept./Oct. 2003
Toxocaríase humana: incidência de infecção em indivíduos residentes na periferia de Campinas, Estado de São Paulo, Brasil
Francisco Anaruma FilhoI; Pedro Paulo ChieffiII, III; Carlos Roberto S. CorreaIV; Eide Dias CamargoV; Edilene P. Real da SilveiraV; Joana José B. AranhaV
IAssociação Cultural e Educacional de Garça – ACEG, SP, Brasil
IIInstituto de Medicina Tropical de São Paulo (LIM 06), São Paulo, SP, Brasil
IIIFaculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil
IVDepartamento de Medicina Preventiva e Social, Faculdade de Medicina da UNICAMP, Campinas, SP, Brasil
VInstituto Adolfo Lutz, São Paulo, SP, Brasil
With the aim of estimating the incidence of infection by Toxocara among residents in the outskirts of Campinas (State of São Paulo, Brazil) two serological surveys, using ELISA anti-Toxocara tests, were performed in January 1999 and January 2000, involving, respectively, 138 and 115 individuals, 75 of which examined in both occasions. Among this group 67 individuals did not show the presence of anti-Toxocara antibodies in 1999, and 12 presented seroconversion in the second survey, revealing an annual incidence rate of 17.9%.
Keywords: Human toxocariasis; Toxocara canis; Incidence; ELISA; Campinas, SP, Brazil.
Dois inquéritos sorológicos empregando testes imunoenzimáticos (ELISA) anti-Toxocara foram realizados em moradores da periferia de Campinas (SP, Brasil) em janeiro de 1999 e janeiro de 2000, envolvendo, respectivamente, 138 e 115 indivíduos escolhidos aleatoriamente. Dos 75 indivíduos examinados em ambas as ocasiões, 67 apresentaram resultados negativos em 1999, observando-se soroconversão em 12 no segundo inquérito. Tais resultados indicam taxa anual de incidência de 17,9% para infecção por Toxocara na região.
Visceral larva migrans is a zoonosis determined by the prolonged migration of some nematode larvae through human tissues. Toxocara canis and T. cati are common ascarids of dogs and cats and considered the principal aetiological agents of this syndrome. Humans are infected after ingestion of either embrionated eggs of those ascarids or tissues of infected paratenic hosts10,13.
Human infection by Toxocara has a worldwide distribution, with variable frequencies, depending on local factors such as close contact with soil contaminated mainly by dog faeces and low income level of the community5,9. The rate of infection and occurrence of symptoms are more frequent in children12,13, principally in rural areas7,10; however, albeit less frequently, adults have also been involved. The most common signs and symptoms include fever, respiratory complaints and hepatomegaly6,10.
Several studies have investigated human infection by Toxocara in Brazil, usually finding high frequencies1,2,4,11,14. However, in this Country, as in many other regions, data on the incidence rate are not available, since almost all field investigations had been designed as transversal studies, considering only one moment of the infection's natural history.
With the aim of estimating the rate of infection by Toxocara among the residents of three boroughs located in the outskirts of the city of Campinas (State of São Paulo, Brazil) two serological surveys were performed: the first in January 1999 and other in January 2000, involving respectively 138 and 115 randomly selected volunteers. Among these, evaluating 75 individuals who were examined in both occasions, was possible to calculate the annual incidence rate.
In each survey the sera were tested for the presence of anti-Toxocara IgG antibodies through enzyme-linked immunosorbent assay (E.L.I.S.A.), using an excretion-secretion antigen obtained from T. canis larvae maintained in Eagle's medium at laboratory8. To avoid cross-reactions with Ascaris antigens, a soil-transmitted roundworm frequent in the studied region and to improve test specificity, each serum was previously submitted to absorption with Ascaris suum extracts4. Serological examinations were carried out at the Serology Section of the Central Laboratory of the Adolfo Lutz Institute employing technique standardized in that laboratory3. The ELISA cut-off had been determined every day using human positive and negative sera.
The objective of the study was clearly explained to all those involved and their informed consent was solicited before collecting blood samples.
The results of the first survey were published elsewhere2 and showed a prevalence rate of 23.9% for Toxocara infection. In the second survey, carried out one year later, 24/115 (20.9%) individuals examined showed anti-Toxocara antibodies in their blood samples. Considering the 75 residents examined in both surveys, 67 had negative results in 1999 and 12 presented seroconversion in the second survey, revealing an annual incidence rate of 17.9% for Toxocara infection in the studied area.
Among the 12 individuals presenting seroconversion to anti-Toxocara antibodies, eight (66.7%) were less than 10 years old, pointing out the role of visceral larva migrans as a pediatric disease10,13 but also calling attention to the occurrence, although not so common, of Toxocara infections in adults.
1. ALDERETE, J.M.S.; JACOB, C.M.A.; PASTORINO, A.C. et al. - Prevalence of Toxocara infection in schoolchildren from the Butantã region, São Paulo, Brazil. Mem. Inst. Oswaldo Cruz, 98: 593-597, 2003. [ Links ]
2. ANARUMA FILHO, F.; CHIEFFI, P.P.; CORREA, C.R.S. et al. - Human toxocariasis: a seroepidemiological survey in the municipality of Campinas (SP), Brazil. Rev. Inst. Med. trop. S. Paulo, 44: 303-307, 2002. [ Links ]
3. CAMARGO, E.D.; NAKAMURA, P.M.; VAZ, A.J. et al. - Standardization of DOT-ELISA for the serological diagnosis of toxocariasis and comparison of the assay with ELISA. Rev. Inst. Med. trop. S.Paulo, 34: 55-60, 1992. [ Links ]
4. CHIEFFI, P.P.; UEDA, M.; CAMARGO, E.D. et al. - Visceral larva migrans: a seroepidemiological survey in five municipalities of São Paulo State, Brazil. Rev. Inst. Med. trop. S. Paulo, 32: 204-210, 1990. [ Links ]
5. CILLA, G.; PÉREZ TRALLERO, E.; GUTIÉRREZ, C.; PART, C. & GOMARIZ, M. - Seroprevalence of Toxocara infection in middle-class and disadvantaged children in Northern Spain (Gipuzkoa, Basque Country). Europ. J. Epidem., 12: 541-543, 1996. [ Links ]
6. EHRHARD, T. & KERNBAUM, S. - Toxocara canis et toxocarose humaine. Bull. Inst. Pasteur, 77: 225-287, 1979. [ Links ]
7. EMBIL, J.A.; TANNER, C.E.; PEREIRA, L.H. et al. - Seroepidemiologic survey of Toxocara canis infection in urban and rural children. Publ. Hlth. (Lond.), 102: 129-133, 1988. [ Links ]
8. GLICKMAN, L.; SCHANTZ, P.; DOMBROSKE, R. & CYPESS, R. - Evaluation of serodiagnostic tests for visceral larva migrans. Amer. J. trop. Med. Hyg., 27: 492-498, 1978. [ Links ]
9. LYNCH, N.R.; EDDY, K.; HODGEN, A.N.; LOPEZ, R.I. & TURNER, K.J. - Seroprevalence of Toxocara canis infection in tropical Venezuela. Trans. roy. Soc. trop. Med. Hyg., 82: 275-281, 1988. [ Links ]
10. MAGNAVAL, J.F.; GLICKMAN, L.T.; DORCHIES, P. & MORASSIN, B. - Highlights of human toxocariasis. Korean J. Parasit., 39: 1-11, 2001. [ Links ]
11. MOREIRA-SILVA, S.F.; LEÃO, M.E.; MENDONÇA, H.F. & PEREIRA, F.E. - Prevalence of anti-Toxocara antibodies in a random sample of inpatients at a chidren's hospital in Vitória, Espirito Santo, Brazil. Rev. Inst. Med. trop. S. Paulo, 40: 259-261, 1998. [ Links ]
12. OVERGAAUW, P.A.M. - Aspects of Toxocara epidemiology: human toxocarosis. Crit. Rev. Microbiol., 23: 215-231, 1997. [ Links ]
13. SCHANTZ, P.M. - Toxocara larva migrans now. Amer. J. trop. Med. Hyg., 41 (suppl.): 21-34, 1989. [ Links ]
14. VIRGINIA, P.; NAGAKURA, K.; FERREIRA, O. & TATENO, S. - Serologic evidence of toxocariasis in Northeast Brazil. Jap. J. med. Sci. Biol., 44: 1-6, 1991. [ Links ]
Instituto de Medicina Tropical de São Paulo
Av. dr. Enéas de Carvalho Aguiar, 470
05403-000 São Paulo, SP, Brasil
Received: 7 July 2003
Accepted: 13 October 2003