Toxocariasis in Cuba: a literature review

Abstract

Human toxocariasis (HT) is a zoonotic disease caused by infection with the larval stage of Toxocara canis, the intestinal roundworm of dogs. Infection can be associated with a wide clinical spectrum varying from asymptomatic to severe organ injury. While the incidence of symptomatic human toxocariasis appears to be low, infection of the human population is widespread. In Cuba, a clear overview on the status of the disease is lacking. Here, we review the available information on toxocariasis in Cuba as a first step to estimate the importance of the disease in the country. Findings are discussed and put in a broader perspective. Data gaps are identified and suggestions on how to address these are presented. The available country data suggest that Toxocara infection of the definitive dog host and environmental contamination with Toxocara spp. eggs is substantial, but information on HT is less conclusive. The availability of adequate diagnostic tools in the country should be guaranteed. Dedicated studies are needed for a reliable assessment of the impact of toxocariasis in Cuba and the design of prevention or control strategies.

Figure 1. Flow diagram of literature searches.

^aAdditional records consisted of five yearly reports on Toxocara antibody detection in patients suspected of VLM or OLM; one book chapter on VLM and a master's thesis on toxocariasis in dogs . ^bReasons for exclusion were: 1. non-relevant association between the keywords (60%) (e.g., Cuba as name of the author, reports on Toxocara published in a Cuban journal, paper, or reference to paper conducted in Cuba in which toxocariasis is mentioned as differential diagnosis, papers on Toxocara vitolorum, etc.); 2. reference to a Cuban report on Toxocara seroprevalence data of Cuba (20%); and 3. replicates of the same report within the Google Scholar search (16%). One record was excluded because none of the co-authors was familiar with the language. ^cEligibility criteria were: 1. subject toxocara, toxocariasis, or larva migrans irrespective of the field or type of publication; and 2. new data about Cuba.

Figure 2. Yearly internal records of the IPK on the serodiagnosis of individuals suspected of human toxocariasis.

Proportion of positive samples in a commercial TES-based ELISA (Diagnostic Automation, Inc., Calabasas, CA) performed by the Department of Parasitology of the IPK. Samples were from patients suspected of OLM or VLM and sent by clinicians across the country for serological confirmation of toxocariasis. No data are available for 2005 and 2008 due to inaccessibility of the commercial ELISA because of the trade embargo with the country. Serum samples were tested anonymously, and information on origin or on the differentiation between suspicion of OLM or VLM syndromes is not available, except for 2003 where all samples analyzed originated from the Ophthalmologic Institute “Ramón Pando Ferrer” and thus were suspicious of OLM. Follow-up of patients was not conducted by the IPK, preventing the confirmation of the suspected diagnosis. ^aData from 2009 are limited to samples received up to the beginning of August 2009.