Screening of Cystic Echinococcosis and Toxocariasis in Urmia Municipal Workers, Northwest Iran

Page: [220 - 229] Pages: 10

  • * (Excluding Mailing and Handling)

Abstract

Background: Echinococcus granulosus and Toxocara spp., the causative agents of hydatid cyst and toxocariasis in humans and animals, are zoonotic infections with medical and veterinary significance respectively.

Aim: Herein, we aimed to investigate the seroprevalence of toxocariasis and cystic echinococcosis in Urmia municipal workers (gardeners and sweepers) in 2018 using ELISA assay.

Objective: There is no precise report on the seroprevalence of toxocariasis and cystic echinococcosis in Urmia municipal workers using ELISA assay. Therefore, this study found an opportunity to investigate this subject.

Methods: A total of 220 blood samples were obtained from municipal workers with an average age of 41.31 ± 9.42. Commercial anti-Toxocara canis and hydatid cyst ELISA kits were used to assess the seroprevalence rates.

Results: Approximately, 14.5% and 2.3% of individuals were seropositive for toxocariasis and hydatidosis, respectively. Consuming unboiled milk and/or raw/uncooked meat and rural conditions are risk factors for toxocariasis. Regarding hydatidosis, consuming unwashed vegetables was the only statistically significant risk factor. Toxocara infection (p = 0.01), but not hydatid cyst (p = 0.05), is more prevalent among sweepers than municipal gardeners.

Conclusion: Due to the occupational condition of municipal workers, they are exposed to many infectious agents; thus, more researches should be done on these populations.

Keywords: Cystic echinococcosis, toxocariasis, municipal, workers, Elisa, Serology, IgG.

Graphical Abstract

[1]
Vrbova, L.; Stephen, C.; Kasman, N.; Boehnke, R.; Doyle-Waters, M.; Chablitt-Clark, A.; Gibson, B.; FitzGerald, M.; Patrick, D.M. Systematic review of surveillance systems for emerging zoonoses. Transbound. Emerg. Dis., 2010, 57(3), 154-161.
[http://dx.doi.org/10.1111/j.1865-1682.2010.01100.x] [PMID: 20202176]
[2]
Hendrickx, E.; Thomas, L.F.; Dorny, P.; Bobić, B.; Braae, U.C.; Devleesschauwer, B.; Eichenberger, R.M.; Gabriël, S.; Saratsis, A.; Torgerson, P.R.; Robertson, L.J.; Dermauw, V. Epidemiology of Taenia saginata taeniosis/cysticercosis: a systematic review of the distribution in West and Central Africa. Parasit. Vectors, 2019, 12(1), 324.
[http://dx.doi.org/10.1186/s13071-019-3584-7] [PMID: 31248445]
[3]
Nur, A.; Abera, B.; Gunse, T. The Significance (Socio-Economic Impact) and Control of Echinococcosis/Hydatidosis: A Review. European Journal of Biological Sciences, 2017, 9, 58-66.
[4]
Ito, A.; Li, T.; Wandra, T.; Dekumyoy, P.; Yanagida, T.; Okamoto, M.; Budke, C.M. Taeniasis and cysticercosis in Asia: A review with emphasis on molecular approaches and local lifestyles. Acta Trop., 2019, 198, 105075.
[http://dx.doi.org/10.1016/j.actatropica.2019.105075] [PMID: 31295430]
[5]
Garcia, H.H.; Moro, P.L.; Schantz, P.M. Zoonotic helminth infections of humans: echinococcosis, cysticercosis and fascioliasis. Curr. Opin. Infect. Dis., 2007, 20(5), 489-494.
[http://dx.doi.org/10.1097/QCO.0b013e3282a95e39] [PMID: 17762782]
[6]
Wen, H.; Vuitton, L.; Tuxun, T.; Li, J.; Vuitton, D.A.; Zhang, W.; McManus, D.P. Echinococcosis: Advances in the 21st Century. Clin. Microbiol. Rev., 2019, 32(2), e00075-e00018.
[http://dx.doi.org/10.1128/CMR.00075-18] [PMID: 30760475]
[7]
Agudelo Higuita, N.I.; Brunetti, E.; McCloskey, C. Cystic Echinococcosis. J. Clin. Microbiol., 2016, 54(3), 518-523.
[http://dx.doi.org/10.1128/JCM.02420-15] [PMID: 26677245]
[8]
Possenti, A.; Manzano-Román, R.; Sánchez-Ovejero, C.; Boufana, B.; La Torre, G.; Siles-Lucas, M.; Casulli, A. Potential risk factors associated with human cystic echinococcosis: systematic review and meta-analysis. PLoS Negl. Trop. Dis., 2016, 10(11), e0005114.
[http://dx.doi.org/10.1371/journal.pntd.0005114] [PMID: 27820824]
[9]
Khademvatan, S.; Yousefi, E.; Rafiei, A.; Rahdar, M.; Saki, J. Molecular characterization of livestock and human isolates of Echinococcus granulosus from south-west Iran. J. Helminthol., 2013, 87(2), 240-244.
[http://dx.doi.org/10.1017/S0022149X12000296] [PMID: 22691442]
[10]
Khademvatan, S.; Majidiani, H.; Foroutan, M.; Hazrati Tappeh, K.; Aryamand, S.; Khalkhali, H.R. Echinococcus granulosus genotypes in Iran: a systematic review. J. Helminthol., 2019, 93(2), 131-138.
[http://dx.doi.org/10.1017/S0022149X18000275] [PMID: 29606162]
[11]
Khalkhali, H.R.; Foroutan, M.; Khademvatan, S.; Majidiani, H.; Aryamand, S.; Khezri, P.; Aminpour, A. Prevalence of cystic echinococcosis in Iran: a systematic review and meta-analysis. J. Helminthol., 2018, 92(3), 260-268.
[http://dx.doi.org/10.1017/S0022149X17000463] [PMID: 28589871]
[12]
Thompson, R. Biology and systematics of Echinococcus. Advances in parasitology; Elsevier, 2017, pp. 65-109.
[13]
Berrett, A.N.; Erickson, L.D.; Gale, S.D.; Stone, A.; Brown, B.L.; Hedges, D.W. Toxocara seroprevalence and associated risk factors in the United States. Am. J. Trop. Med. Hyg., 2017, 97(6), 1846-1850.
[http://dx.doi.org/10.4269/ajtmh.17-0542] [PMID: 29016316]
[14]
Lee, R.M.; Moore, L.B.; Bottazzi, M.E.; Hotez, P.J. Toxocariasis in North America: a systematic review. PLoS Negl. Trop. Dis., 2014, 8(8), e3116.
[http://dx.doi.org/10.1371/journal.pntd.0003116] [PMID: 25166906]
[15]
Lötsch, F.; Vingerling, R.; Spijker, R.; Grobusch, M.P. Toxocariasis in humans in Africa - A systematic review. Travel Med. Infect. Dis., 2017, 20, 15-25.
[http://dx.doi.org/10.1016/j.tmaid.2017.10.009] [PMID: 29037977]
[16]
Macpherson, C.N. The epidemiology and public health importance of toxocariasis: a zoonosis of global importance. Int. J. Parasitol., 2013, 43(12-13), 999-1008.
[http://dx.doi.org/10.1016/j.ijpara.2013.07.004] [PMID: 23954435]
[17]
Strube, C.; Heuer, L.; Janecek, E. Toxocara spp. infections in paratenic hosts. Vet. Parasitol., 2013, 193(4), 375-389.
[http://dx.doi.org/10.1016/j.vetpar.2012.12.033] [PMID: 23312872]
[18]
Moreira-Silva, S.F.; Rodrigues, M.G.; Pimenta, J.L.; Gomes, C.P.; Freire, L.H.; Pereira, F.E. Toxocariasis of the central nervous system: with report of two cases. Rev. Soc. Bras. Med. Trop., 2004, 37(2), 169-174.
[http://dx.doi.org/10.1590/S0037-86822004000200011] [PMID: 15094904]
[19]
Rostami, A.; Ma, G.; Wang, T.; Koehler, A.V.; Hofmann, A.; Chang, B.C.H.; Macpherson, C.N.; Gasser, R.B. Human toxocariasis - A look at a neglected disease through an epidemiological ‘prism’. Infect. Genet. Evol., 2019, 74, 104002.
[http://dx.doi.org/10.1016/j.meegid.2019.104002] [PMID: 31412276]
[20]
Woodhall, D.M.; Eberhard, M.L.; Parise, M.E. Neglected parasitic infections in the United States: toxocariasis. Am. J. Trop. Med. Hyg., 2014, 90(5), 810-813.
[http://dx.doi.org/10.4269/ajtmh.13-0725] [PMID: 24808249]
[21]
Kuenzli, E.; Neumayr, A.; Chaney, M.; Blum, J. Toxocariasis-associated cardiac diseases- A systematic review of the literature. Acta Trop., 2016, 154, 107-120.
[http://dx.doi.org/10.1016/j.actatropica.2015.11.003] [PMID: 26571071]
[22]
Zibaei, M.; Sadjjadi, S.M. Trend of toxocariasis in Iran: a review on human and animal dimensions. Majallah-i Tahqiqat-i Dampizishki-i Iran, 2017, 18(4), 233-242.
[PMID: 29387094]
[23]
Maleki, B; Khorshidi, A; Gorgipour, M; Mirzapour, A; Majidiani, H; Foroutan, M. Prevalence of Toxocara spp. eggs in soil of public areas in Iran: a systematic review and meta-analysis. Alexandria journal of medicine, 2018, 54, 97-101.
[24]
Monteiro, KM; Cardoso, MB; Follmer, C; Da Silveira, NP; Vargas, DM; Kitajima, EW Echinococcus granulosus antigen B structure: subunit composition and oligomeric states. 2012, 6.
[http://dx.doi.org/10.1371/journal.pntd.0001551]
[25]
Rafiei, A.; Hemadi, A.; Maraghi, S.; Kaikhaei, B.; Craig, P. Human cystic echinococcosis in nomads of south-west Islamic Republic of Iran. Eastern Mediter. Health J., 2007, 13(1), 41-48.
[26]
Ma, G.; Holland, C.V.; Wang, T.; Hofmann, A.; Fan, C-K.; Maizels, R.M.; Hotez, P.J.; Gasser, R.B. Human toxocariasis. Lancet Infect. Dis., 2018, 18(1), e14-e24.
[http://dx.doi.org/10.1016/S1473-3099(17)30331-6] [PMID: 28781085]
[27]
Mandal, S.; Mandal, M.D. Human cystic echinococcosis: epidemiologic, zoonotic, clinical, diagnostic and therapeutic aspects. Asian Pac. J. Trop. Med., 2012, 5(4), 253-260.
[http://dx.doi.org/10.1016/S1995-7645(12)60035-2] [PMID: 22449514]
[28]
ARYAMAND, S.; KHADEMVATAN, S.; TAPPEH, KH.; HESHMATIAN, B.; JELODAR, A. in vitro and in vivo Scolicidal Activities of Holothuria leuco-spilota Extract and CeO2 Nanoparticles against Hydatid Cyst. Iran. J. Parasitol., 2019, 14, 269-279.
[PMID: 31543915]
[29]
Navvabi, A.; Homaei, A.; Khademvatan, S.; Khadem Ansari, M.H.; Keshavarz, M. in vitro study of the scolicidal effects of Echinometra mathaei spine and shell extracts on hydatid cyst protoscolices. Exp. Parasitol., 2019, 203, 19-22.
[http://dx.doi.org/10.1016/j.exppara.2019.05.009] [PMID: 31153894]
[30]
Yousefi, E.; Rafiei, A.; Rashidi, I.; Khademvatan, S.; Foroutan, M. Molecular characterization of Echinococcus granulosus in paraffin-embedded human tissues from Southwest Iran. Asian Pac. J. Trop. Med., 2019, 12, 507.
[http://dx.doi.org/10.4103/1995-7645.271290]
[31]
Beaver, P.C.; Snyder, C.H.; Carrera, G.M.; Dent, J.H.; Lafferty, J.W. Chronic eosinophilia due to visceral larva migrans; report of three cases. Pediatrics, 1952, 9(1), 7-19.
[PMID: 14911260]
[32]
Fillaux, J.; Magnaval, J-F. Laboratory diagnosis of human toxocariasis. Vet. Parasitol., 2013, 193(4), 327-336.
[http://dx.doi.org/10.1016/j.vetpar.2012.12.028] [PMID: 23318165]
[33]
Elefant, G.R.; Roldán, W.H.; Seeböck, A.; Kosma, P. Evaluation of a di-O-methylated glycan as a potential antigenic target for the serodiagnosis of human toxocariasis. Parasite Immunol., 2016, 38(4), 236-243.
[http://dx.doi.org/10.1111/pim.12311] [PMID: 26896376]
[34]
Jin, Y.; Shen, C.; Huh, S.; Sohn, W-M.; Choi, M-H.; Hong, S-T. Serodiagnosis of toxocariasis by ELISA using crude antigen of Toxocara canis larvae. Korean J. Parasitol., 2013, 51(4), 433-439.
[http://dx.doi.org/10.3347/kjp.2013.51.4.433] [PMID: 24039286]
[35]
Magnaval, J-F.; Fabre, R.; Maurières, P.; Charlet, J-P.; de Larrard, B. Application of the western blotting procedure for the immunodiagnosis of human toxocariasis. Parasitol. Res., 1991, 77(8), 697-702.
[http://dx.doi.org/10.1007/BF00928685] [PMID: 1805214]
[36]
Mohamad, S.; Azmi, N.C.; Noordin, R. Development and evaluation of a sensitive and specific assay for diagnosis of human toxocariasis by use of three recombinant antigens (TES-26, TES-30USM, and TES-120). J. Clin. Microbiol., 2009, 47(6), 1712-1717.
[http://dx.doi.org/10.1128/JCM.00001-09] [PMID: 19369434]
[37]
Noordin, R.; Smith, H.V.; Mohamad, S.; Maizels, R.M.; Fong, M.Y. Comparison of IgG-ELISA and IgG4-ELISA for Toxocara serodiagnosis. Acta Trop., 2005, 93(1), 57-62.
[http://dx.doi.org/10.1016/j.actatropica.2004.09.009] [PMID: 15589798]
[38]
Peixoto, P.L.; Nascimento, E.; Cançado, G.G.L.; Miranda, R.R.; Rocha, R.L.; Araújo, R.N.; Fujiwara, R.T. Identification of candidate antigens from adult stages of Toxocara canis for the serodiagnosis of human toxocariasis. Mem. Inst. Oswaldo Cruz, 2011, 106(2), 200-206.
[http://dx.doi.org/10.1590/S0074-02762011000200014] [PMID: 21537681]
[39]
Roldán, W.H.; Elefant, G.R.; Ferreira, A.W. Deglycosylation of Toxocara excretory-secretory antigens improves the specificity of the serodiagnosis for human toxocariasis. Parasite Immunol., 2015, 37(11), 557-567.
[http://dx.doi.org/10.1111/pim.12248] [PMID: 26315805]
[40]
Watthanakulpanich, D.; Smith, H.V.; Hobbs, G.; Whalley, A.J.; Billington, D. Application of Toxocara canis excretory-secretory antigens and IgG subclass antibodies (IgG1-4) in serodiagnostic assays of human toxocariasis. Acta Trop., 2008, 106(2), 90-95.
[http://dx.doi.org/10.1016/j.actatropica.2008.01.008] [PMID: 18343348]
[41]
Moreira, G.M.S.G.; Telmo, Pde.L.; Mendonça, M.; Moreira, Â.N.; McBride, A.J.A.; Scaini, C.J.; Conceição, F.R. Human toxocariasis: current advances in diagnostics, treatment, and interventions. Trends Parasitol., 2014, 30(9), 456-464.
[http://dx.doi.org/10.1016/j.pt.2014.07.003] [PMID: 25089038]
[42]
Abdi, J.; Darabi, M.; Sayehmiri, K. Epidemiological situation of toxocariasis in Iran: meta-analysis and systematic review. Pak. J. Biol. Sci., 2012, 15(22), 1052-1055.
[http://dx.doi.org/10.3923/pjbs.2012.1052.1055] [PMID: 24261119]
[43]
Garedaghi, Y. Seroprevalence of toxocariasis in children in East-Azerbaijan Province, Iran. Cukurova Medical Journal, 2013, 38, 581-586.
[http://dx.doi.org/10.17826/cutf.55222]
[44]
Hosseini-Safa, A.; Mousavi, S.M.; Bahadoran Bagh Badorani, M.; Ghatreh Samani, M.; Mostafaei, S.; Yousofi Darani, H. Seroepidemiology of toxocariasis in children (5–15 yr old) referred to the pediatric clinic of Imam Hossein Hospital, Isfahan, Iran. Iran. J. Parasitol., 2015, 10(4), 632-637.
[PMID: 26811731]
[45]
Sarkari, B.; Alirezaei, R.; Layegh Gigloo, A.; Rezaei, Z.; Mikaeili, F.; Bahreini, M.S.; Fararouei, M. Seroprevalence and risk factors for Toxocara infection among children in a rural community in Fars province, southern Iran. Parasite Immunol., 2018, 40(11), e12582.
[http://dx.doi.org/10.1111/pim.12582] [PMID: 30117165]
[46]
Khoshnood, S; Pestehchian, N; Hejazi, SH; Rafiei, A; Soleimani, A; Ahmadi, M Toxocara seroprevalence and associated risk factors among ilam children, west of Iran., Archives of Pediatric Infectious Diseases, 2019, 7.
[47]
Aghamolaie, S.; Seyyedtabaei, S.J.; Behniafar, H.; Foroutan, M.; Saber, V.; Hanifehpur, H.; Mehravar, S.; Rostami, A. Seroepidemiology, modifiable risk factors and clinical symptoms of Toxocara spp. infection in northern Iran. Trans. R. Soc. Trop. Med. Hyg., 2019, 113(3), 116-122.
[http://dx.doi.org/10.1093/trstmh/try118] [PMID: 30407595]
[48]
Baghani, Z.; Khazan, H.; Sohrabi, M.R.; Rostami, A. Seroprevalence of Toxocara infection among healthy individuals referred to the medical center laboratories in Tehran City, Capital of Iran. Novelty in Biomedicine, 2018, 6, 68-73.
[49]
Rezaiemanesh, M.R.; Afzalaghaee, M.; Hamidi, S.; Eshaghzadeh, A.; Paydar, M.; Hejazi, S.H. Prevalence of toxocariasis and its related risk factors in humans, dogs and cats in northeastern Iran: a population-based study. Trans. R. Soc. Trop. Med. Hyg., 2019, 113(7), 399-409.
[http://dx.doi.org/10.1093/trstmh/trz011] [PMID: 30892638]
[50]
Arefkhah, N.; Shadzi, M.R.; Mikaeili, F.; Sarkari, B.; Esfandiari, F.; Goudarzi, F. Seroprevalence and associated risk factors of toxocariasis among nomads in Boyer-Ahmad County, southwest Iran. Trans. R. Soc. Trop. Med. Hyg., 2019.
[PMID: 31825495]
[51]
Ashtari, S.; Khademvatan, S.; Abasi, E.; Aminpour, A. Designing and standardizing Toxocara serologic diagnostic kit and determining anti-Toxocara antibodies frequency in patients referred to health care centers in Urmia (northwest of Iran). J. Parasit. Dis., 2019, 43(2), 270-275.
[http://dx.doi.org/10.1007/s12639-019-01088-5] [PMID: 31263333]
[52]
Holland, C.V. Knowledge gaps in the epidemiology of Toxocara: the enigma remains. Parasitology, 2017, 144(1), 81-94.
[http://dx.doi.org/10.1017/S0031182015001407] [PMID: 26670118]
[53]
Smith, H.; Holland, C.; Taylor, M.; Magnaval, J.F.; Schantz, P.; Maizels, R. How common is human toxocariasis? Towards standardizing our knowledge. Trends Parasitol., 2009, 25(4), 182-188.
[http://dx.doi.org/10.1016/j.pt.2009.01.006] [PMID: 19269251]
[54]
Poulsen, C.S.; Skov, S.; Yoshida, A.; Skallerup, P.; Maruyama, H.; Thamsborg, S.M.; Nejsum, P. Differential serodiagnostics of Toxocara canis and Toxocara cati- is it possible? Parasite Immunol., 2015, 37(4), 204-207.
[http://dx.doi.org/10.1111/pim.12181] [PMID: 25711956]
[55]
Schabussova, I.; Amer, H.; van Die, I.; Kosma, P.; Maizels, R.M. O-methylated glycans from Toxocara are specific targets for antibody binding in human and animal infections. Int. J. Parasitol., 2007, 37(1), 97-109.
[http://dx.doi.org/10.1016/j.ijpara.2006.09.006] [PMID: 17087964]
[56]
Budke, C.M.; Carabin, H.; Ndimubanzi, P.C.; Nguyen, H.; Rainwater, E.; Dickey, M.; Bhattarai, R.; Zeziulin, O.; Qian, M.B. A systematic review of the literature on cystic echinococcosis frequency worldwide and its associated clinical manifestations. Am. J. Trop. Med. Hyg., 2013, 88(6), 1011-1027.
[http://dx.doi.org/10.4269/ajtmh.12-0692] [PMID: 23546806]
[57]
Galeh, T.M.; Spotin, A.; Mahami-Oskouei, M.; Carmena, D.; Rahimi, M.T.; Barac, A.; Ghoyounchi, R.; Berahmat, R.; Ahmadpour, E. The seroprevalence rate and population genetic structure of human cystic echinococcosis in the Middle East: A systematic review and meta-analysis. Int. J. Surg., 2018, 51, 39-48.
[http://dx.doi.org/10.1016/j.ijsu.2018.01.025] [PMID: 29367032]
[58]
Cardona, GA; Carmena , DJVp A review of the global prevalence, molecular epidemiology and economics of cystic echinococcosis in production animals. 2013, 192, 10-32.
[59]
Sarkari, B.; Rezaei, Z. Immunodiagnosis of human hydatid disease: Where do we stand? World J. Methodol., 2015, 5(4), 185-195.
[http://dx.doi.org/10.5662/wjm.v5.i4.185] [PMID: 26713278]
[60]
Coupland, U.; Dobosz, S.; Zawadka, K.; Marczyńska, M. Cystic echinococcosis in a child infected with HIV. Ann. Parasitol., 2012, 58(2), 101-103.
[PMID: 25165762]
[61]
Devi, C.S.; Parija, S.C. A new serum hydatid antigen detection test for diagnosis of cystic echinococcosis. Am. J. Trop. Med. Hyg., 2003, 69(5), 525-528.
[http://dx.doi.org/10.4269/ajtmh.2003.69.525] [PMID: 14695090]
[62]
Ravinder, P.T.; Parija, S.C.; Rao, K.S. Urinary hydatid antigen detection by coagglutination, a cost-effective and rapid test for diagnosis of cystic echinococcosis in a rural or field setting. J. Clin. Microbiol., 2000, 38(8), 2972-2974.
[http://dx.doi.org/10.1128/JCM.38.8.2972-2974.2000] [PMID: 10921961]
[63]
Swarna, S.R.; Parija, S.C. Evaluation of Dot-ELISA and enzyme-linked immuno-electrotransfer blot assays for detection of a urinary hydatid antigen in the diagnosis of cystic echinococcosis. Trop. Parasitol., 2012, 2(1), 38-44.
[http://dx.doi.org/10.4103/2229-5070.97238] [PMID: 23508649]
[64]
Xu, M.Q.; Zhu, B.; Xue, H.C.; Li, X.; Guo, X.R.; Zhang, Y.H.; Li, H. [Reexamination of specific antibodies in sera of cystic echinococccosis patients with IgG negative seroresponse]. Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi, 2002, 20(3), 148-151.
[PMID: 12567989]
[65]
Lawn, S.D.; Bligh, J.; Craig, P.S.; Chiodini, P.L. Human cystic echinococcosis: evaluation of post-treatment serologic follow-up by IgG subclass antibody detection. Am. J. Trop. Med. Hyg., 2004, 70(3), 329-335.
[http://dx.doi.org/10.4269/ajtmh.2004.70.329] [PMID: 15031526]
[66]
Mirzanejad-Asl, H.; Ghoreishi, M.; Ghahramani, A.; Mehmandar, W. Serological and sonographical Survey of hydatid disease in moghan plain of Iran. Res. J. Med. Sci., 2010, 4, 75-80.
[http://dx.doi.org/10.3923/rjmsci.2010.75.80]
[67]
Zibaei, M.; Azargoon, A.; Ataie-Khorasgani, M.; Ghanadi, K.; Sadjjadi, S.M. The serological study of cystic echinococcosis and assessment of surgical cases during 5 years (2007-2011) in Khorram Abad, Iran. Niger. J. Clin. Pract., 2013, 16(2), 221-225.
[http://dx.doi.org/10.4103/1119-3077.110156] [PMID: 23563466]
[68]
Rakhshanpour, A.; Harandi, M.F.; Moazezi, S.; Rahimi, M.; Mohebali, M.; Mowlavi, G.; Babaei, Z.; Ariaeipour, M.; Heidari, Z.; Rokni, M. Seroprevalence of human hydatidosis using ELISA method in qom province, central iran. Iran. J. Parasitol., 2012, 7(3), 10-15.
[PMID: 23109956]
[69]
Gholami, S.; Tanzifi, A.; Sharif, M.; Daryani, A.; Rahimi, M-T.; Mirshafiee, S.; Sarvi, S. Demographic aspects of human hydatidosis in Iranian general population based on serology: A systematic review and meta-analysis. Vet. World, 2018, 11(10), 1385-1396.
[http://dx.doi.org/10.14202/vetworld.2018.1385-1396] [PMID: 30532491]
[70]
Muñoz-Guzmán, M.A.; del Río-Navarro, B.E.; Valdivia-Anda, G.; Alba-Hurtado, F. The increase in seroprevalence to Toxocara canis in asthmatic children is related to cross-reaction with Ascaris suum antigens. Allergol. Immunopathol. (Madr.), 2010, 38(3), 115-121.
[http://dx.doi.org/10.1016/j.aller.2009.09.007] [PMID: 20227158]