Abstract
BackgroundHuman toxocariasis, caused by Toxocara canis, T. cati, and T. vitulorum of dogs, cats and ruminants respectively, is recognized as an important zoonotic infection worldwide. The typical clinical syndromes of toxocariasis in humans are ocular larva migrans (OLM) and visceral larva migrans (VLM). The most commonly affected sites of OLM are the peripheral retina and/or vitreous humor. In Sri Lanka, there is a dearth of information on prevalence of ocular infection in our population. Therefore, the present study was carried out to determine the prevalence of Toxocara antibodies in suspected OLM patients and to describe demographic factors and clinical manifestations of seropositive patients. A total of 250 clinically suspected ocular toxocariasis cases referred by consultant eye surgeons to the Department of Parasitology, University of Peradeniya were studied between the years 1995 to April 2015.MethodsData (age, sex, fundoscopic findings) were gathered from the referral letters. Each serum sample was subjected to Toxocara excretory – secretory antigen ELISA (TES - ELISA).ResultsOut of the 250 cases, 155 (62%) were seropositive. The age range of the seropositive cases was 1 to 78 years with the mean age of 27 years. The highest seropositivity (25/155) was observed within the age group of 10 to 14 years. The most frequent clinical presentation of seropositive OLM cases were unilateral reduced vision and red eye. The other symptoms include tearing, photophobia and leukokoria. A high proportion of seropositive OLM cases had uveitis (34.19%) followed by reduced vision (21.94%), vitritis (12.9%) and choroiditis (7.74%). However none of these clinical manifestations were significantly associated with TES-ELISA seropositivity except vitreits (X2 = 8.557, p = 0.003).ConclusionIn conclusion, the results of this study showed high seroprevalence of toxocariasis among clinically suspected OLM cases confirming the toxoplasmic etiology. This high rate of Toxocara seropositivity in ocular patients should alert ophthalmologists in Sri Lanka to include toxocariasis in the differential diagnosis of ocular diseases presented with the symptoms and signs stated above.
Highlights
Human toxocariasis, caused by Toxocara canis, T. cati, and T. vitulorum of dogs, cats and ruminants respectively, is recognized as an important zoonotic infection worldwide
Demographic details From January 1995 to April 2015, two hundred and fifty ocular larva migrans (OLM) suspected patients were identified in the patient records
Clinical manifestations and Seropositivity The most frequent clinical presentation of seropositive OLM cases were uveitis (34.19%) followed by reduced vision (21.94%), vitritis (12.9%) and choroiditis (7.74%) (Table 3)
Summary
Human toxocariasis, caused by Toxocara canis, T. cati, and T. vitulorum of dogs, cats and ruminants respectively, is recognized as an important zoonotic infection worldwide. The typical clinical syndromes of toxocariasis in humans are ocular larva migrans (OLM) and visceral larva migrans (VLM). The present study was carried out to determine the prevalence of Toxocara antibodies in suspected OLM patients and to describe demographic factors and clinical manifestations of seropositive patients. Human toxocariasis is a zoonotic disease caused by several species of the nematode round worm Toxocara. Toxocara spp. are common intestinal round worms parasitizing a wide range of domestic, agricultural, and wild animals. The clinical spectrum of human toxocariasis ranges from asymptomatic cases to systemic infections. The recognized clinical manifestations include classic and incomplete visceral toxocarisis (VLM), ocular toxocarisis (OLM), neurological toxocarisis (NLM), covert toxocariasis and asymptomatic toxocarisis [8]
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