Cases Of Toxocariasis Research Articles

The seroprevalence of toxocariasis and related risk factors in children in Ho Chi Minh City, Vietnam: results from a school-based cross-sectional study.

Children are especially vulnerable to Toxocara infection and its severe complications; however, there have not been any published data on the disease prevalence and treatment effectiveness in the population of Vietnamese children. This study was conducted to determine the prevalence of toxocariasis and explore factors associated with Toxocara infection in children aged 3-15 y in Ho Chi Minh City, Vietnam. We conducted a cross-sectional study using a multistage cluster sampling approach in public schools. Blood samples were collected, and toxocariasis cases were confirmed, based on a history of contact with dogs/cats and positive anti-Toxocara antibody detection via ELISA. We calculated the percentage of seropositive children across gender, grade levels, districts and caregiver education. Multiple regression models were employed to identify potential risk factors. Anti-Toxocara antibodies were found in 14.2% of the 986 children studied. Significant variations in seropositivity were observed across grade levels, districts and caregiver education levels. Multivariable analysis identified caregiver education, contact with dogs/cats and improper handling of pet feces as seropositivity risk factors. This was the first community-based prevalence study of toxocariasis in a pediatric population in Vietnam. Implementation of preventive measures such as public education, routine fecal examinations and chemotherapeutic treatment of animals is highly recommended.

Case of Toxocariasis in a Cat Presented to a Private Veterinary Clinic

In this study, a case of zoonotic toxocariasis seen in a cat brought to a private veterinary clinic is presented. The case data were obtained from a 2.5 kg male tabby cat, aged 6 months, who was presented to a private veterinary clinic. Following the examination of the cat, vomiting was observed as a side effect of the anaesthetic administered during the eye removal surgery. Macroscopic parasites were detected in the stomach contents. In order to identify the species, the parasite was placed in a tube filled with 70% alcohol. The Toxocara cati was later identified microscopically at the Parasitology laboratory of Selçuk University Faculty of Veterinary Medicine. Our case report contains useful information since toxocariasis infection in cats is rarely seen in the stomach contents and has zoonotic importance. This case is presented with the hope of raising awareness, especially among veterinarians working in animal hospitals and small animal clinics.

Deglycosylation of Excretory-Secretory Antigens of the Second-Stage Larvae of Toxocara cati Improves Its Efficacy in the Diagnosis of Human Toxocariasis.

Toxocariasis is an important zoonotic infection, especially in tropical areas. One of the significant challenges in the serodiagnosis of human toxocariasis is the cross-reaction of Toxocara antigens with other parasites due to their relatively similar glycan structures. Removing the glycan structure from Toxocara excretory-secretory (TES) antigens may increase the efficacy of these antigens in the diagnosis of toxocariasis. The current study aimed to assess the efficacy of deglycosylated Toxocara cati excretory-secretory (dTES) antigens for the serodiagnosis of human toxocariasis. Toxocara ES antigens were prepared from T. cati second-stage larvae and deglycosylated using sodium hydroxide (NaOH). The TES antigens, along with the dTES antigens, were used in an ELISA as well as a western blotting system for the detection of anti-Toxocara antibodies. Sera samples collected from 30 confirmed cases of toxocariasis, 30 patients with other diseases, and 30 healthy subjects were evaluated by both systems. The sensitivity of TES and dTES ELISA for the diagnosis of human toxocariasis was 96.67% (95% CI = 82.78-99.92) and 93.33% (95% CI = 77.93-99.18), respectively, while the specificity of dTES (88.33%; 95% CI = 77.43-95.18) increased significantly compared to the TES (80.00%; 95% CI = 67.67-89.22). The sensitivity of both antigens was 100% (95% CI = 88.43-100) by the western blotting system. Moreover, the specificity of TES and dTES antigens was 95% (95% CI = 86.08-98.96) and 98.33% (95% CI = 91.06-99.96), respectively, when using the western blotting system. Results of the current study indicate that the chemical removal of the glycan epitopes of T. cati ES antigens significantly reduces cross-reactivity rates with other parasitic infections. Considering the findings of the present study, the dTES antigens seem to be suitable antigens for the serodiagnosis of human toxocariasis.

Toxocariasis. Difficult diagnosis in practice of pediatrician

Parasitic nematodes of the genus Toxocara are socio-economically important zoonotic pathogens. These parasites are usually directly transmitted to the human host through the fecal-oral route and can cause toxocariasis and related complications, including allergic and neurological disorders. Although tens of millions of people are estimated to have been exposed to Toxocara spp. or are infected with them, global epidemiological information on the relationship between seropositivity and toxocariasis is limited. Recent results show that in some countries the impact of toxocariasis on human health is increasing. The purpose of this review was to analyze modern data on the epidemiology, pathogenesis, clinical and laboratory manifestations and therapy of toxocariasis. Material and methods. The analysis of publications in PubMed, EMBASE and Web of Science systems in the period from January 1950 to September 2020, highlighting studies documenting the epidemiological, pathogenetic, clinical and laboratory aspects of toxocariasis. In addition, we analyzed clinical cases of toxocariasis among patients of the departments of the Pediatric Research and Clinical Center for Infectious Diseases. The article discusses the basic information about toxocars, summarizes the key aspects of the pathogenesis, diagnosis and treatment of toxocariasis, its prevalence, and gives recommendations for the prevention and control of this disease.

The Effect of Infection by Toxocariasis on Some Biochemical Parameters in Some Areas of Salah Al-Din Governorate

The current study examined 277 blood samples of people, from both sexes of different ages, living in different areas of Salah Al-Din Governorate (Tikrit, Al-Alam and Baiji districts). The study was conducted from November, 2018 to June, 2019. All participants were secrened to investigate the incidence of toxocariasis using IgG TES-ELISA technique. The results showed that the rate of infection with toxocariasis was 22%. It was found an increase in cholesterol concentrations within age group 48-58 years and amounted to 185.8 mg/dl, and highest rate of increase in triglycerides was recorded within age group 15-25 years (168.1 mg/dl). The highest percentage of total protein was recorded within age group 26- 36 years (6.67 mg/dl). As for lipoprotein tests, highest percentage of high-density lipoproteins in age group 48-58 years was recorded (53 mg/dl), while low-density lipoproteins were highest in age group 48-58 years (100.8 mg/dl), and in very low-density lipoproteins the highest percentage within age group 15-25 years (33.5 mg/dl). The highest percentage of AST liver enzymes was recorded in age group 15-25 years and the percentage was 20.6 u/l. The highest percentage of ALT was recorded in age group 26-36 years (20.1 u/l) and 15-25 years (20 u/l). It is concluded that This age group continues to be exposed to infection with toxocariasis, which leads to presence large numbers of live larvae which secrete their antigens in the body and thus spread of toxoplasmosis, and the increase in proportion of fats is caused by poor oxidation of fatty acids and increased production of hepatic fatty acids Which leads to a delay in breakdown of lipoproteins, and the increase in level of AST, ALT enzyme occurs in cases of hepatitis and cirrhosis and may be associated with advanced cases of toxocariasis.

Seroprevalence of Toxocara spp. infection in Southeast Asia and Taiwan.

Human toxocariasis is a worldwide neglected zoonotic parasitic disease and caused mainly by Toxocara canis, and to a lesser event, by T. cati. There are only 16 epidemiological studies and 5 clinical toxocariasis case reports in 11 Southeast Asia countries and Taiwan (SEAT) that were found by searching data from PubMed in the period from January 1992 to August 2019. The overall seroprevalence in SEAT varied from 3.9% to 84.6% chiefly detected by using T. canis larval excretory-secretory antigen (TcES)-based ELISA. Playing with dogs or contacting Toxocara eggs from the contaminated soil or vegetables or eating raw meats/viscera containing encapsulated larvae seem likely the major risk factors leading to human toxocariasis in SEAT. Nevertheless, undertaking comprehensive seroepidemiological studies to establish the baseline data and beware of clinical toxocariasis cases by physicians as well as establishing adequate serodiagnostic methods in detection of Toxocara infection, e.g., TcES-based immunoblotting method in helminth endemic SEA are strongly required.

Image Case:Ocular Toxocariasis in 14 Years Old Male.

Toxocariasis is one of zoonotic infections all over the world that is caused by Toxocara canis and Toxocara cati. Infection with Toxocara occurs by accidentlal ingestion of embryonated eggs or larvae which have been shed in the feces of infected animals. After ingestion of the eggs, release of infective larvae in the small intestine occurs and then these penetrate the intestine then to the circulation, and then to different organs. Clinical presentation of toxocariasis in humans varies from asymptomatic infection to severe organ damage, which depends on the load of the parasite, the involved organs, and inflammatory response of the host. Particularly, depending on the involved organ, two clinical types can occur: systemic toxocariasis (which is known as visceral larva migrans) and ocular toxocariasis . The majority of the ocular toxocariasis cases are unilateral. To reach definitive diagnosis of ocular toxocariasis, biopsy of infected tissue should be obtained for histological demonstration of the Toxocara larva which is difficult in clinical practice. So, we depend on the presence of typical ophthalmologic signs and the presence of serum antibody to the Toxocara larvae for diagnosis of ocular toxocariasis. A 14 years old male presented by progressive decrease in visual acuity in the left eye with no history of trauma or medications, with blood picture showed no esinophilia. Slit lamp examination was normal. Coloured fundus photography and fluorescein angiography of the left eye revealed evidence of fibrous band stretching from the optic disc to a peripheral retinal mass located in the far peripheral nasal retina which is highly suggestive of ocular toxocariasis. Patient received medical treatment in the form of systemic corticosteroids ( 1mg/kg) and diethyl carbamazine ( 6 mg/kg per day) for one month then reexamination was done and coloured fundus photography of the eye revealed marked improvement of the traction bands on the macula with improvement of visual acuity .

A clinical case of visceral toxocariasis as a cause of eosinophilic polyserositis

The aim of the present report is to describe a clinical case of toxocariasis. 37-year - old man was admitted to Pirogov Municipal Clinical Hospital No.1 in Moscow. He was presented with intense generalized abdominal pain. Three months before the described hospitalization, the patient had acute bronchitis, then pneumonia. During the examination there were found hyperthermia, ascites, shortness of breath, sweating, hypereosinophilia. Patient lost 8 kilos over the last 6 months. There were arisen many hypotheses, however, after a more detailed survey about patient's life it turned out that he travelled a lot. So that the parasitosis became the main conjecture, which later was confirmed by serological tests.

TOXOCARIASIS AS THE ACTUAL PROBLEM IN KURSK REGION

The urgency of the problem of toxocarosis in the territory of the Kursk region is caused by the increase in the incidence among the children's population, the contamination of environmental objects with toksokar eggs. In this regard, it is necessary to conduct large-scale studies on the helminth infections of carnivorous animals living in urban areas to establish a realistic picture of their infection with toxocarosis and assess the sanitary and helminthological state of sand in children's play houses near Kursk, and determine the risk of infection of children with geohelminthiasis.One of the leading places in the structure of infectious and parasitic morbidity in the Kursk region is still occupied by parasitic diseases. According to the state report “On the sanitary and epidemiological well-being in the Kursk region in 2017”, 1125 cases of parasitic diseases are registered in the region. In the structure of parasitosis 97.4% are made up of helminthiasis. Contact helminthiasis had the largest share, represented by enterobiasis – 93%, geohelminthiasis was 4%, biohelminthoses – 1%. Among geohelminthic infections in 2017, two nosological forms were registered – ascariasis and toxocarosis, compared with 2016, the incidence of the latter increased by 10.4%. A total of 23 cases of toxocariasis were registered in the region, it is noteworthy that the proportion of children among the infested persons was 82.6% [3]. True incidence can be much higher, since in most cases infection with toxcar for a long time is asymptomatic and is detected by chance during laboratory examination [4].Toxocarosis is a parasitic disease caused by the migration of helminth larvae of dogs – Toxocara canis in humans, less often – Toxocara mystax of cats and characterized by a complex of syndromes and symptoms, referred to as visceral larva migrans. Such factors as an increase in the number of dogs and cats in populated areas, their high prevalence of toxocars, the intensity of egg excretion by mature helminths that live in the intestines of animals, and the stability of eggs in the environment exert on the spread of toxocariasis among people. In modern conditions, toxocarosis becomes the most socially significant helminth infection with a high risk of infection in cities [1].

Challenging diagnoses of toxocariasis: a report of two cases

The present study illustrates two cases of Toxocara canis infection: a 77-year-old man presenting with bilateral uveitis, sepsis, and non-convulsive status epilepticus (patient A); and a 63-year-old woman with a history of treated breast cancer, presenting with sight loss and paralysis of the right eye, neurological symptoms, pulmonary embolism, pneumonia, and a post traumatic vertebral fracture (patient B). Both diagnoses were challenging because the acute comorbidities withdrew the attention from the actual cause of the disease, and in one case the steroid treatment possibly affected the laboratory indexes. The lack of response to antibiotics and the involvement of specific organs and districts suggested parasitic infection. Indeed, immunoblot assay revealed the presence of specific T. canis immunoglobulin G antibodies. Both patients improved with albendazole 800 mg/die (400 mg ×2) for 28 days; the neurological state normalized, while sight and eye motility remained impaired. Overall, the findings from these two toxocariasis cases indicate that the occurrence of severe neurological symptoms associated with ocular involvement should generate suspicion of parasitic infection rather than leading to differential diagnosis of common presentations such as bacterial and viral infections or autoimmune diseases.

Toxocariasis In A Lioness In Jos Zoo, Nigeria

Wild animals in Zoos across the globe are kept for aesthetic, educational, recreational and conservation purposes. Collections of rare and endangered species are also preserved in Zoos. Lions do well in captivity but are prone to excessive worm burden especially round worms and tapeworms though these conditions can easily be managed with adequate Veterinary services. Incidence of toxocariasis in captive African lions (Panthera leo) in Nigeria has largely not been reported. Jos Zoo and Wildlife Park both in Plateau State of Nigeria have lost significant number of lions to toxocariasis due to inadequate Veterinary attention A fatal case of toxocariasis in an African Lioness in Jos Zoological Garden, Nigeria was presented as a case study.

Prevalence of Toxocara antibodies among patients clinically suspected to have ocular toxocariasis: A retrospective descriptive study in Sri Lanka

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.

C型慢性肝炎治癒後に出現した肝トキソカラ症の1例

C型慢性肝炎治癒後に出現した肝トキソカラ症の1例

A Case Diagnosed Toxocariasis After the Intiation of Treatment with Steroids for Eosinophilic Granulomatosis with Polyangitis (EGPA)

Toxocariasis causes a variety of symptoms. We experienced a case of toxocariasis which was initially treated with steroids for Eosinophilic Granulomatosis with Polyangitis (EGPA). A 53-year-old woman with the past medical history of bronchial asthma presented at the outpatient department in the middle of August. She complained of chest discomfort lasting for one week. Ischemic heart disease was initially suspected due to ST depression on ECG and positive Troponin I. However coronary angiography did not reveal any abnormality. Her symptoms continued and after one month she presented at the hospital again with an elevated eosionophil count. Chest computed tomography showed ground glass opacities on both lungs. She was diagnosed as having EGPA based on her clinical symptoms and the results of the blood test which were consistent with the diagnostic criteria of EGPA. After prednisolone was prescribed, her symptoms and eosinophilia dramatically improved. However, we found that the histology of the lung and kidney was not compatible with EGPA and the result of serum parasite antibodies turned out to be strongly positive for toxocariasis after initiating predonisolone. Based on this result, we concluded that our patient had a case of toxocariasis and prescribed albendazole in addition to prednisolone. The patient completed a 3-week course of albendazole and a 3-month course of prednisolone without any problems. In general, steroids are not commonly used as a treatment of toxocariasis, however it seems to have been effective in this case. Toxocariasis shows a variety of symptoms and can be misdiagnosed as other diseases such as EGPA.

A Case of Toxocariasis in a Patient with Cecal Cancer Mimicking Hepatic Metastasis

Toxocariasis is a common helminth infection and the most common cause of peripheral blood eosinophilia. The clinical presentation of liver toxocariasis is often confused with primary or metastatic hepatic tumors. Here, we report on a 52-year-old man admitted with cecal cancer and eosinophilia. Computerized tomography (CT) scans revealed multiple lesions with peripheral enhancement in the liver, and T1- and T2-weighted images revealed isointensity. The patient underwent right hemicolectomy and an exploratory laparotomy with a liver biopsy. Resection of the cecal specimen revealed an adenocarcinoma, while the liver biopsy revealed an eosinophilic abscess with no evidence of malignancy. A serologic test showed a marked increase in specific immunoglobulin G antibody concentrations against Toxocara canis and daily antiparasitic treatment with albendazole (800 mg per day for 7 days) was initiated. Follow-up CT scans indicated that all liver masses and eosinophilia were resolved. (Korean J Med 2015;89:714-718)

Identification of immunodominant antigens for the laboratory diagnosis of toxocariasis

To identify immunodominant antigens of Toxocara canis recognised by Toxocara-infected sera as recombinant reagents for immunodiagnosis of toxocariasis. Pooled sera from human cases of toxocariasis were used to identify immunodominant antigens by immunoscreening a T. canis larval expression cDNA library. The positive clones were sequenced to reveal the identity of the antigens. The recombinant proteins were expressed in E. coli and then used to confirm their immunoreaction with sera of humans with toxocariasis. Two chosen antigens were also used to differentiate Toxocara infection from other helminth infections in mice. Eleven antigens with immunodiagnostic potential were identified, including two C-type lectins (CTLs) that reacted strongly with the Toxocara-positive serum pool. The first CTL (Tc-CTL-1) is the same as TES-32, previously identified as a major immunodominant component of TES; the second CTL (Tc-CTL-2) is a novel C-type lectin sharing 83% amino acid sequence identity within the functional domain of Tc-CTL-1. The E. coli-expressed recombinant Tc-CTL-1 was strongly recognised by the Toxocara-positive serum pool or sera from animals experimentally infected with T. canis. Reactivity with recombinant Tc-CTL-1 was higher when the unreduced protein was used in an enzyme-linked immunosorbent assay (ELISA), dot-blot assay or Western blot test compared to the protein under reduced condition. Both recombinant Tc-CTL-1- and Tc-CTL-2-based ELISAs were able to differentiate T. canis infection from other helminth infections in experimentally infected mice. Both Tc-CTL-1 and Tc-CTL-2 were able to differentiate Toxocara infection from other helminth infections and could potentially be used as sensitive and specific immunodiagnostic antigens.

Recurrent toxocariasis due to chronic urticaria and successful treatment with prolonged albendazole therapy.

Toxocariasis is a worldwide human helminthiasis, especially seen in temperate and tropical climate regions around the world. The diagnosis of this disease is performed on the basis of clinical symptoms and laboratory findings. Albendazole is one of the treatment choices for toxocariasis, with a currently recommended regimen of 10 mg/kg/day in two doses (400 mg twice daily) for 5 days. However, there is no precise consensus about the duration of the treatment. In this article, we report a case of toxocariasis; the patient visited our infectious disease polyclinic with complaints of long-term itching and urticarial skin lesions that were resistant to routine treatment and that recurred. Then, recurrent disease was resolved and skin lesions were diminished after prolonged albendazole therapy.

Field evaluation of a rapid diagnostic test to detect antibodies in human toxocariasis

Human toxocariasis which is caused mainly by the larvae of Toxocara canis and Toxocara cati, is a worldwide zoonotic disease that can be a potentially serious human infection. The enzyme-linked immunosorbent assay (ELISA) using T. canis excretory–secretory (TES) antigens harvested from T. canis larvae is currently the serological test for confirming toxocariasis. An alternative to producing large amounts of Toxocara TES and improved diagnosis for toxocariasis is through the development of highly specific recombinant antigens such as the T. canis second stage larva excretory–secretory 30kDa protein (recTES-30). The aim of this study was to evaluate the sensitivity and specificity of a rapid diagnostic kit (RDT, named as iToxocara kit) in comparison to recTES-30 ELISA in Serendah Orang Asli village in Selangor, Malaysia. A total of 133 subjects were included in the study. The overall prevalence rates by ELISA and RDT were 29.3% and 33.1%, respectively, with more positive cases detected in males than females. However, no association was found between toxocariasis and gender or age. The percentage sensitivity, specificity, positive predictive value and negative predictive value of RDT were 85.7%, 90.1%, 80% and 93.2%, respectively. The prevalence for toxocariasis in this population using both ELISA and RDT was 27.1% (36/133) and the K-concordance test suggested good agreement of the two tests with a Cohen's kappa of 0.722, P<0.01. In addition, the followed-up Spearman rank correlation showed a moderately high correlation at R=0.704 and P<0.01. In conclusion, the RDT kit was faster and easier to use than an ELISA and is useful for the laboratory diagnosis of hospitalized cases of toxocariasis.

Evaluation of Toxocara cati Excretory-Secretory Larval Antigens in Serodiagnosis of Human Toxocariasis.

Toxocariasis is the clinical term that is applied to infection in the human host with Toxocara species larvae. Serological tests are important tools for the diagnosis of toxocariasis. The aim of this study was to evaluate the excretory-secretory (ES) antigens of T. cati larvae using enzyme-linked immunosorbent assay (ELISA) and also Western blotting for serodiagnosis of human toxocariasis. The ES antigens were prepared from T. cati third-stage larvae. Serum samples were obtained from 33 confirmed cases of toxocariasis, 35 patients infected with other parasitic diseases, and 30 from healthy individuals tested with ELISA and immunoblotting. The ELISA showed appropriate performance in term of specificity (96.7%) and sensitivity (97.0%). Electrophoretic analysis of T. cati ES antigens revealed a range of 20- to 150-kDa fractions. The highest sensitivity was achieved with 42- and 50-kDa fractions. The ELISA analyses using T. cati ES antigens demonstrated good sensitivity and specificity compared to T. canis ES as antigens for diagnosis of human toxocariasis. Accordingly, application of Western blotting, based on 42- and 50-kDa fractions of ES antigens, can be recommended for the accurate diagnosis of toxocariasis.

Epidemiology of human toxocariasis in Poland - A review of cases 1978-2009.

Toxocariasis is a helminthozoonosis due to the infection of humans with larvae belonging to the Toxocara genus. Humans become infected as a result of accidental consumption of infected eggs containing third stage larvae (L3) nematodes from Toxocara canis or Toxocara cati species. Toxocariasis was recognized for the first time in the early 1950s, and the first cases of toxocariasis in Poland were described a few years later. Toxocariasis is clinically classified into several types: classic and incomplete visceral larva migrans (VLM) syndrome, ocular larva migrans (OLM) syndrome, neurological toxocariasis (NLM), covert toxocariasis and asymptomatic toxocariasis. In 1994-2005, 18,367 sera of people suspected of being infected with Toxocara were analysed, 1.8-76% had anti- Toxocara antibodies. In the period 1978-2009, 1,022 clinical cases of toxocariasis were recognized in Poland. In the opinion of the authors, in order to reduce the frequency of toxocariasis in human populations, some prophylaxis should undertaken, e.g. public education of zoonotic diseases, systematic control of animal, deworming of pets, cleaning pets' faeces by the owners.