SUMMARYThe lack of specific laboratorial diagnosis methods and precise symptoms makes the toxocariasis a neglected disease in Public Health Services. This study aims to determine the frequency of Toxocara spp. infection in children attended by the Health Public Service of Hospital Municipal de Maringá, South Brazil. To evaluate the association of epidemiological and clinical data, an observational and cross-section study was carried out. From 14,690 attended children/year aged from seven month to 12 years old, 450 serum samples were randomly collected from September/2004 to September/2005. A questionnaire was used to evaluate epidemiological, clinical and hematological data. An ELISA using Toxocara canis larval excretory-secretory products as antigen detected 130 (28.8%) positive sera, mainly between children from seven month to five years old (p = 0.0016). Significant correlation was observed between positive serology for Toxocara, and frequent playing in sandbox at school or daycare center (p = 0.011) and the presence of a cat at home (p = 0.056). From the families, 50% were dog owners which exposed soil backyards. Eosinophilia (p = 0.776), and signs and symptoms analyzed (fever p = 0.992, pneumonia p = 0.289, cold-like symptoms p = 0.277, cough p = 0.783, gastrointestinal problems p = 0.877, migraine p = 0.979, abdominal pain p = 0.965, joint pain p = 0.686 and skin rash p = 0.105) could not be related to the presence of anti-Toxocara antibodies. Therefore, two asthmatics children showed titles of 1:10,240 and accentuated eosinophilia (p = 0.0001). The authors emphasize the needs of prevention activities.

Background Giardia duodenalis infects humans and other mammals by ingestion of cysts in contaminated water or food, or directly in environments with poor hygiene. Eight assemblages, designated A–H, are described for this species.Methodology/Principal FindingsWe investigated by microscopy or by direct immunofluorescence technique the occurrence of G. duodenalis in 380 humans, 34 animals, 44 samples of water and 11 of vegetables. G. duodenalis cysts present in samples were genotyped through PCR-RFLP of β giardin and glutamate dehydrogenase (gdh) genes and sequencing of gdh. The gdh gene was amplified in 76.5% (26/34) of the human faeces samples with positive microscopy and in 2.9% (1/34) of negative samples. In 70.4% (19/27) of the positive samples were found BIV assemblage. In two samples from dogs with positive microscopy and one negative sample, assemblages BIV, C, and D were found. Cysts of Giardia were not detected in water samples, but three samples used for vegetable irrigation showed total coliforms above the allowed limit, and Escherichia coli was observed in one sample. G. duodenalis BIV was detected in two samples of Lactuca sativa irrigated with this sample of water. BIV was a common genotype, with 100% similarity, between different sources or hosts (humans, animals and vegetables), and the one most often found in humans.Conclusions/SignificanceThis is the first study in Brazil that reports the connection among humans, dogs and vegetables in the transmission dynamics of G. duodenalis in the same geographic area finding identical assemblage. BIV assemblage was the most frequently observed among these different links in the epidemiological chain.

The presence of helminths and protozoans in public squares and lawns of the city of Maringá, southern Brazil, during winter and summer was assessed in order to evaluate their seasonal fluctuations in relation to edaphic and climatic factors. Samples were collected from January 2003 through June 2004 in 90% (13) of all public squares covered by sand, and in 30% (4) of all lawns used as leisure areas. The samples were analysed quantitatively by modified centrifugal-flotation and sedimentation in water techniques, and qualitatively by a method based on positive larval thermo-hydrotropism. Meteorological data were recorded, and physical, chemical and structural characteristics of the soil were analysed. One hundred and thirty samples of sand from squares, 65 in summer and 65 in winter, and 40 samples of grass from lawns, 20 in each season, were collected. All samples from lawns, 62 (95.38%) from squares in winter and 45 (69.23%) in summer, contained protozoans and/or helminths. Eggs of Toxocara spp. were the most frequently observed parasites in both winter and summer in squares (P < 0.0001) and in lawns (P = 0.6142), being equally distributed among the different locations (P = 0.2038). Species diversity was lower in winter; fewer parasites were found in summer. This region, with a tropical climate and a mild winter dry season, has favourable edaphic and climatic conditions for soil contaminants to persist year-round. In addition, the high frequency of animals such as dogs and cats and the poor sanitary measures in force made it possible for zoonoses to be transmitted in the public spaces.

A concomitant study was carried out, of the association of positive serology for Toxocara spp. in 90 children who played in public squares used for leisure, with the frequency with which each child used these areas, and the presence of eggs of Toxocara spp. in the sand or grass in these locations. The sand and grass of their peridomiciles and school playgrounds, as well as the feces of their dogs were also analyzed for Toxocara. Serum samples were tested for IgG antibodies to Toxocara canis excreted-secreted larval antigens by ELISA, and blood samples for eosinophilia. The water-sedimentation technique was used to evaluate the presence of parasite eggs in the sand and grass turfs, and in feces of the dogs that also frequented these locations. 16/90 (17.8%) of the children were seropositive for Toxocara spp. There was a positive association between seropositivity in children who played in the public squares six or seven times a week, with a parasite load above 1.1 eggs/g of sand, as well as with contamination of the peridomicile, even at less than 1.0 egg/g of sand. Eosinophilia, the habit of geophagy, age from one to four years, and the presence of parasitized pet dogs were also positively correlated with seropositivity in the children. Eggs were found in 15/15 (100%) of the public squares, 17/90 (18.9%) of the peridomiciles, 3/13 (23.1%) of the schools, and 12/41 (29.3%) of the dogs living in the peridomiciles investigated.

SUMMARYToxocariasis is a worldwide public-health problem that poses major risks to children who may accidentally ingest embryonated eggs of Toxocara. The objectives of this study were to investigate the occurrence of anti-Toxocara spp. antibodies in children and adolescents and the variables that may be involved, as well as environmental contamination by Toxocara spp. eggs, in urban recreation areas of north central mesoregion, Paraná State, Brazil. From June 2005 to March 2007. a total of 376 blood samples were collected by the Public Health Service from children and adolescents one to 12 years old, of both genders. Samples were analyzed by the indirect ELISA method for detection of anti-Toxocara antibodies. Serum samples were previously absorbed with Ascaris suum antigens, and considered positive with a reagent reactivity index ≥1. Soil samples from all of the public squares and schools located in the four evaluated municipalities that had sand surfaces (n = 19) or lawns (n = 15) were analyzed. Of the 376 serum samples, 194 (51.6%) were positive. The seroprevalence rate was substantially higher among children aging one to five years (p = 0.001) and six to eight years (p = 0.022). The clinical signs and symptoms investigated did not show a statistical difference between seropositive and seronegative individuals (p > 0.05). In 76.5% of the investigated recreation places, eggs of Toxocara were detected in at least one of the five collected samples. Recreation areas from public schools were 2.8 times more contaminated than from public squares. It is important to institute educational programs to inform families and educators, as well as to improve sanitary control of animals and cleaning of the areas intended for recreation in order to prevent toxocariasis.

Few studies have assessed the contamination of vegetables at Brazilian production sites. From April 1996 to December of 1997, the sanitary conditions of raw consumed vegetables sold in the Feira do Produtor de Maringá were investigated. We based the analyses on the contamination of vegetables, of the producers (stool samples and material under the fingernails) and of the water used for irrigation. It was observed that 16.6% of 144 samples of five different types of vegetables were contaminated with intestinal parasites. Forty three of 163 individuals (26%) were infected with one or more parasites. Only three of the 49 samples of material under the fingernails analyzed were positive for intestinal parasites. Analysis of samples of the water used for vegetable irrigation showed that the water did not satisfy bacteriological standards of potability. We conclude that in the investigated area the contamination of vegetables occurred during the production phase and that a sanitary education campaign directed at the producers is needed.

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The objectives of this study were to evaluate the contamination by eggs of Toxocara in sandy areas or grass lawns of outdoor recreation areas that are used by children, and the frequency of seroprevalence in children, from three cities of fewer than 45,000 inhabitants in Paraná, Brazil. From May 2005 to December 2007, five samples were taken from each of 13 sandy sites and 18 grass lawns, all from plazas and public schools. Blood samples from children aged 0-12 years were analysed by immunoassay for anti-Toxocara IgG. The soil samples were processed by floatation and sedimentation. Eggs of Toxocara spp. were present in 44.7% (38/85) of the samples from grassed areas and in 21.4% (15/70) of the sand samples. The lawns were 2.16 times more contaminated than the sand (P = 0.0009). However, the epidemiological variables showed no statistically significant difference between seropositive (36.8%; 130/353), and seronegative children. The rate of seropositivity was higher in children aged 0-5 years (P = 0.03), who were 1.94 times more likely to develop persistent wheezing (P = 0.02).