Global seroprevalence of Toxocara infection in children: a systematic review and meta-analysis of a neglected parasitic threat.

PURPOSE: 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.

METHODS

We 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).

RESULTS

A 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%.

CONCLUSION

The 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.