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Human Toxocariasis in Rural Brazilian Amazonia: Seroprevalence, Risk Factors, and Spatial Distribution

This population-based cross-sectional study of 403 rural settlers in Brazilian Amazonia revealed an overall rate of IgG seropositivity to Toxocara canis excretory-secretory larval antigen of 26.8% (95% confidence interval [CI], 22.5–31.4%). Multilevel logistic regression analysis identified current infection with hookworm (odds ratio [OR], 2.32; 95% CI, 1.11–4.86) and residence in the most recently occupied sectors of the settlement (OR, 1.81; 95%CI, 1.3–2.52) as significant risk factors for Toxocara seropositivity; age > 14 years (OR, 0.46; 95% CI, 0.28–0.73) and the presence of cats in the household (OR, 0.57; 95% CI, 0.32–1.02) appeared to be protective. Two significant high-prevalence clusters were detected in the area, together comprising 38.9% of the seropositive subjects; households in the clusters had slightly lower socioeconomic status and were less likely to have cats as pets. The obstacles for controlling human toxocariasis in this and other tropical rural settings are discussed.

Received November 14, 2007. Accepted for publication March 30, 2008.

Acknowledgments: The authors thank the inhabitants of Ramal do Granada for their enthusiastic participation in the study; Sebastião Bocalom Rodrigues, Damaris de Oliveira, and Nésio M. Carvalho (Municipal Government of Acrelândia) for their logistic support; Adamílson L. de Souza for their help in fieldwork, and Estéfano A. de Souza and Bruna A. Luz for data management. The authors also thank Dr. Cristina Miuki Abe Jacob for her valuable suggestions.

Financial support: This study was supported by a grant from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, 05/51988-0) and funds from the Laboratório de Investigação Médica em Imunologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (LIM 48). MdSN is supported by a PhD scholarship from FAPESP and MUF receives a scholarship from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil.

^* Address correspondence to Guita Rubinsky-Elefant, Instituto de Medicina Tropical de São Paulo, Laboratório de Soroepidemiologia e Imunobiologia, Av. Dr Enéas de Carvalho Aguiar, 470–4° andar, CEP: 05403-000 São Paulo (SP), Brazil. E-mail: guitare{at}usp.br

Authors’ addresses: Guita Rubinsky-Elefant and Rosely S. Malafronte, Institute of Tropical Medicine of São Paulo, Av. Dr. Enéas de Carvalho Aguiar 470, Cerqueira César, 05403-000 São Paulo (SP), Brazil, Tel: 55-11-30617026, Fax: 55-11-30617026, E-mails: guitare{at}usp.br and rmalafronte{at}usp.br. Mônica da Silva-Nunes and Marcelo U. Ferreira, Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes 1374, 05508-900 São Paulo (SP), Brazil, Tel: 55-11-30917746, Fax: 55-11-30917417, E-mails: msnunes1{at}yahoo.com.br and muferrei{at}usp.br. Pascoal T. Muniz, Department of Health Sciences, Federal University of Acre, BR-364 km 4, Campus Universitário, 69915-900 Rio Branco (AC), Brazil, Tel: 55-68-39012648, Fax: 55-68-3901-2648, E-mail: pascoal{at}ufac.br.