title: Toxocara seroprevalence among clinically healthy individuals, pregnant women and psychiatric patients and associated risk factors in Shandong Province, Eastern China.
abstract: BACKGROUND
  Toxocarosis is a widespread zoonosis caused by the ascarid nematodes Toxocara canis and Toxocara cati, which primarily infect dogs and cats, respectively. Most human infections with Toxocara are asymptomatic; however, some infected individuals may develop a serious illness and even death. Nevertheless, epidemiological knowledge regarding the prevalence and risks associated with Toxocara infection is limited in China. Therefore, we performed a cross-sectional pilot study and estimated the seroprevalence of Toxocara infection in humans in Shandong Province, eastern China for the first time, from June 2011 to July 2013, involving clinically healthy individuals, pregnant women and psychiatric patients, aiming to attract public attention to Toxocara infection.
  
  
  RESULTS
  Seroprevalence of Toxocara was determined using an enzyme-linked immunosorbent assay based on a cross-sectional study conducted in Qingdao and Weihai, Shandong Province, eastern China. Factors potentially associated with Toxocara infection were identified by logistic regression analysis. The overall Toxocara seroprevalence among the study population (n = 2866) was 12.25%, and a significantly higher seroprevalence in psychiatric patients (16.40%, 73/445) than that in clinically healthy individuals (13.07%, 187/1431) and pregnant women (9.19%, 91/990) was revealed. Univariate analyses suggested that keeping dogs at home (OR = 0.06, 95% CI 0.05-0.08, P<0.001), contact with cats and dogs (OR = 0.42, 95% CI 0.33-0.53, P<0.001) and exposure with soil (OR = 0.37, 95% CI 0.28-0.49, P<0.001) were risk factors associated with Toxocara infection.
  
  
  CONCLUSIONS
  The present study revealed, for the first time, that human infection with Toxocara is common in eastern China, posing a significant public health concern. Increasing human and dog populations, population movements and climate change all will serve to increase the importance of this zoonosis. Further studies under controlled conditions are necessary to define potential morbidity associated with Toxocara infection.
authors.affiliation: State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province, People's Republic of China; College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Cong
authors.affiliation: State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province, People's Republic of China; College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province, People's Republic of China.
authors.forename: Xiao-Xuan
authors.initials: XX
authors.lastname: Zhang
authors.affiliation: Affiliated Hospital of Medical College, Qingdao University, Qingdao, Shandong Province, People's Republic of China.
authors.forename: Na
authors.initials: N
authors.lastname: Zhou
authors.affiliation: Weihai Wendeng Central Hospital, Weihai, Shandong Province, People's Republic of China.
authors.forename: Chang-Zheng
authors.initials: CZ
authors.lastname: Yu
authors.affiliation: State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province, People's Republic of China.
authors.forename: Jia
authors.initials: J
authors.lastname: Chen
authors.affiliation: Wendeng Municipal Hospital, Weihai, Shandong Province, People's Republic of China.
authors.forename: Xiang-Yang
authors.initials: XY
authors.lastname: Wang
authors.affiliation: Wendeng People's Hospital, Weihai, Shandong Province, People's Republic of China.
authors.forename: Bing
authors.initials: B
authors.lastname: Li
authors.affiliation: College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province, People's Republic of China.
authors.forename: Ai-Dong
authors.initials: AD
authors.lastname: Qian
authors.affiliation: State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province, People's Republic of China; College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province, People's Republic of China.
authors.forename: Xing-Quan
authors.initials: XQ
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology / Q000276:immunology; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D014119:Toxocara / Q000276:immunology*; D014120:Toxocariasis / Q000150:complications / Q000453:epidemiology / Q000276:immunology; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan
references.citation: Int J Parasitol. 2013 Nov;43(12-13):999-1008
references.pmid: 23954435
references.citation: Vet Parasitol. 2011 Jun 10;178(3-4):319-23
references.pmid: 21330056
references.citation: Infect Genet Evol. 2012 Oct;12(7):1344-8
references.pmid: 22569289
references.citation: Boll Ist Sieroter Milan. 1989;68(1):93-6
references.pmid: 2491292
references.citation: J Korean Med Sci. 2012 Sep;27(9):1105-8
references.pmid: 22969260
references.citation: Asian Pac J Trop Biomed. 2013 Mar;3(3):211-6
references.pmid: 23620840
references.citation: J Parasitol. 2013 Jun;99(3):537-9
references.pmid: 23738711
references.citation: Vet Parasitol. 2012 Aug 13;188(1-2):48-52
references.pmid: 22480882
references.citation: Vet Parasitol. 2008 Mar 25;152(1-2):94-100
references.pmid: 18207641
references.citation: J Parasitol. 1999 Apr;85(2):252-6
references.pmid: 10219304
references.citation: PLoS One. 2013 Apr 23;8(4):e62606
references.pmid: 23626838
references.citation: Vet Parasitol. 2004 May 7;121(1-2):115-24
references.pmid: 15110409
references.citation: Yonsei Med J. 2008 Apr 30;49(2):224-9
references.pmid: 18452258
references.citation: Parasit Vectors. 2012 Jul 28;5:152
references.pmid: 22839365
references.citation: Vet Parasitol. 2013 Apr 15;193(4):398-403
references.pmid: 23305972
references.citation: Am J Trop Med Hyg. 2008 Oct;79(4):552-7
references.pmid: 18840743
references.citation: PLoS Negl Trop Dis. 2012;6(2):e1382
references.pmid: 22389726
references.citation: Am J Trop Med Hyg. 2014 Apr;90(4):670-81
references.pmid: 24515946
references.citation: PLoS Negl Trop Dis. 2012;6(11):e1886
references.pmid: 23133689
references.citation: PLoS Negl Trop Dis. 2009;3(3):e400
references.pmid: 19333373
references.citation: Turkiye Parazitol Derg. 2012;36(4):258-9
references.pmid: 23339951
references.citation: Vet Parasitol. 2013 Apr 15;193(4):342-52
references.pmid: 23290279
references.citation: Korean J Parasitol. 2012 Mar;50(1):23-7
references.pmid: 22451730
references.citation: ScientificWorldJournal. 2013 Jun 09;2013:572089
references.pmid: 23844404
references.citation: Rev Inst Med Trop Sao Paulo. 2013;55(3):
references.pmid: 23740017
references.citation: Rev Soc Bras Med Trop. 2011 Jul-Aug;44(4):461-6
references.pmid: 21860891
references.citation: Vet Parasitol. 2011 Nov 24;182(1):41-53
references.pmid: 21813243
references.citation: Case Rep Med. 2011;2011:503913
references.pmid: 21629809
references.citation: Acta Trop. 2013 Oct;128(1):90-5
references.pmid: 23845771