Toxocariasis in internationally adopted children: Seroprevalence, diagnostic and therapeutic strategies

Approximately one in six internationally adopted children shows Toxocara spp. seropositivity. While IgG-TES ELISA is a sensitive screening tool, confirmatory Western blot substantially improves specificity and diagnostic stewardship, reducing unnecessary second-level investigations. A substantial proportion of seropositive children likely represent clinically inactive seropositivity, for which it is not possible to differentiate recent infection from past exposure to the parasite. Integrating serology with eosinophil counts, IgE levels, and clinical assessment is crucial to distinguish active from resolved infection and to identify children who require clinical and instrumental follow-up and albendazole therapy, thereby avoiding unnecessary interventions.