Global seroprevalence of Toxocara infection in children: a systematic review and meta-analysis of a neglected parasitic threat
摘要
Toxocara infection poses a significant public health threat, particularly in children. This systematic review and meta-analysis aimed to provide a global estimate of the seroprevalence of anti-Toxocara antibodies (hereafter ‘T-seroprevalence’) in children and identify associated risk factors.
MethodsWe conducted a systematic search of international scientific databases from January 1, 1980, to November 20, 2024. Population-based studies reporting T-seroprevalence in children (aged ≤ 19 years) using serological methods were included. We stratified studies into two groups: (1) general pediatric populations (healthy children) and (2) selected pediatric populations (children with specific diseases or conditions). Random-effects meta-analysis was used to estimate global and regional pooled T-seroprevalence with 95% confidence intervals (CIs). Subgroup and meta-regression analyses were conducted to explore heterogeneity and risk factors. The protocol for this study was registered on PROSPERO (CRD42024603522).
ResultsA total of 231 studies (242 datasets) were included for general children representing 95,544 children from 57 countries. The global pooled T-seroprevalence (at 95% CI) was 20.3% (17.9–22.8). The highest seroprevalence was observed in Southeast Asia (37.3%) and Africa (31.9%), while the lowest was in the Eastern Mediterranean (9.1%) and Europe (10.8%). Significant risk factors included rural residence (OR = 2.2), contact with dogs (OR = 1.8), and drinking untreated water (OR = 2.6). Among children with specific diseases or conditions (74 datasets), T-seroprevalence was 23.2% in those with neurological disorders, 21.3% with allergic conditions, 6.15% with uveitis, and 21.6% with other disorders. Immigrant children showed a T-seroprevalence of 8.3%.
ConclusionThe global burden of T-seroprevalence in children remains significant, with marked geographic disparities and strong associations with socioeconomic and environmental factors. Children with specific health conditions demonstrate slightly higher T-seroprevalence, warranting targeted screening and preventive interventions, particularly in high-burden regions. These findings underscore the need for integrated control programs, particularly in high-burden areas, combining school-based screening, veterinary–public health collaborations, and targeted hygiene education to reduce the substantial global burden of Toxocara infection in children.