Predictors of treatment failure in pediatric toxocariasis: A two-part study in Ho Chi Minh City, Vietnam

Abstract

Objective: To identify factors associated with the therapeutic effectiveness of albendazole in children with Toxocara canis infection in Ho Chi Minh City, Vietnam.

Methods: The study was conducted from April 2022 to December 2023 and consisted of two phases. Phase 1 was a cross-sectional study involving 986 children aged 3-15 years in Ho Chi Minh City, Vietnam, to determine the seroprevalence of Toxocara spp. using ELISA IgG testing. Phase 2 was an interventional study conducted in children with compatible clinical manifestations and positive ELISA results. Patients received albendazole at a dose of 15 mg/kg/day for 5 days. Clinical and laboratory reassessments were performed 6 months after treatment.

Results: Of 986 school children included in the cross-sectional study, 140 (14.2%) had positive Toxocara ELISA results and 107 completed follow-up after treatment. At 6 months, 96.3% showed complete resolution of clinical symptoms, 71.0% had normalized eosinophil counts, and 57.9% had total IgE levels returned to the normal range. The treatment failure rate was 72.0%. Multivariable analysis identified place of residence and inappropriate disposal of dog and cat feces as independent factors associated with treatment failure (P<0.05).

Conclusions: Environmental and hygiene-related factors, particularly improper disposal of dog and cat feces, were independently associated with treatment failure.

Keywords

Toxocariasis / Factors associated with treatment outcomes / Albendazole / Treatment effectiveness of toxocariasis in children

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