Toxoplasma gondii infection: seroprevalence and associated risk factors among primary school children in the capital area of the Republic of the Marshall Islands.

Although Toxoplasma gondii infection is commonly prevalent in the tropical/subtropical regions, the prevalence of toxoplasmosis in the Republic of the Marshall Islands (RMI) remains unclear. A seroepidemiological survey was undertaken for investigating T. gondii infection in primary school children (PSC) using the latex agglutination (LA) test in the capital area of RMI. Information on demographic characteristics and environmental risk factors was collected via a structured questionnaire. Logistic regression model was applied for multivariate analysis. The overall infection rate of T. gondii was found to be 54.8%. Significant gender differences were found at different urbanization levels. PSC with LA titers of ≥ 1:1,024, indicating high responders, were found to be younger age group than others (8.7 years vs. 10.3 years, P = 0.003); moreover, infection rates among both age groups as well as high responders showed a decreasing trend with age. Multivariate analysis revealed that residing in urban rather than suburban settings was associated with increased risk of infection (P = 0.04). No associations were found between raw meat consumption, drinking unboiled water, and cleaning of cat hutch using gloves. This is the first serological survey of T. gondii infection among PSC in RMI and could help in the development of strategies in the future for disease prevention and control of T. gondii transmission.

Seroepidemiology of Toxocara canis infection among primary schoolchildren in the capital area of the Republic of the Marshall Islands.

BACKGROUND: Toxocariasis, which is predominantly caused by Toxocara canis (T. canis) infection, is a common zoonotic parasitosis worldwide; however, the status of toxocariasis endemicity in the Republic of the Marshall Islands (RMI) remains unknown. METHODS: A seroepidemiological investigation was conducted among 166 primary school children (PSC) aged 7-12 years from the capital area of the RMI. Western blots based the excretory-secretory antigens of larval T. canis (TcES) was employed, and children were considered seropositive if their serum reacted with TcES when diluted at a titer of 1:64. Information regarding demographic characteristics of and environmental risk factors affecting these children was collected using a structured questionnaire. A logistic regression model was applied to conduct a multivariate analysis. RESULTS: The overall seropositive rate of T. canis infection was 86.75% (144/166). In the univariate analysis, PSC who exhibited a history of feeding dogs at home (OR = 5.52, 95% CI = 1.15-26.61, p = 0.02) and whose parents were employed as nonskilled workers (OR = 2.86, 95% CI = 1.08-7.60, p = 0.03) demonstrated a statistically elevated risk of contracting T. canis infections. Cleaning dog huts with gloves might prevent infection, but yielded nonsignificant effects. The multivariate analysis indicated that parental occupation was the critical risk factor in this study because its effect remained significant after adjusting for other variables; by contrast, the effect of dog feeding became nonsignificant because of other potential confounding factors. No associations were observed among gender, age, consuming raw meat or vegetables, drinking unboiled water, cleaning dog huts with gloves, or touching soil. CONCLUSIONS: This is the first serological investigation of T. canis infection among PSC in the RMI. The high seroprevalence indicates the commonness of T. canis transmission and possible human risk. The fundamental information that the present study provides regarding T. canis epidemiology can facilitate developing strategies for disease prevention and control.