Title: Toxocara infection in pregnant women: seroprevalence and risk factors
Version: 0 Date: 08 Mar 2024
Reviewer's report:
BMC Women's Health manuscript - "Toxocara infection in pregnant women: seroprevalence
and risk factors"
This manuscript contains major shortcomings which give rise to many issues
A - A careful editing is required to improve both the English and the style:
The use of certain words is not appropriated in the manuscript context and some sentences are
hardly understandable
Examples:
- in "Introduction":  "latitude" instead of "climate"
- in "Materials & Methods"
"A questionnaire filled by participants included options for demographic...."
"Options" instead of "items" or "questions"
"If the absorbance value was < 10% cutoff, the samples had considered negative"
- in "Conclusion"
"positive cases of T. canis are typical in pregnant women"
B - The whole list of references should be checked for pertinence and accordance with the
numbers in the text.
One example: the description of the spectrum of human toxocariasis (...overt toxocariasis
appears in three forms: VT, OT, and NT [7]) calls for the reference #7. This has nothing related
to a clinical description!
"Barrera MG, Leonardi D, Bolmaro RE, Echenique CG, Olivieri AC, Salomon CJ, et al. .
In vivo evaluation of albendazole microspheres for the treatment of Toxocara canis larva
migrans. Eur J Pharm Biopharm. 2010;75:451-4"
C - "Introduction" should be drastically improved
First, this section should be abridged. The authors gave a long description of the clinical
picture of human toxocariasis which is out of topic for a larger part. Moreover, they adopted a
classification (VT, OT and NT), the used the acronym VLM which is absent in this classification.
They wrote questionable statements such as "differential diagnosis of VLM is challenging " and
gave a list of parasites or parasitic diseases to support their statement.
This review is not the place to give a lecture of internal medicine or infectiology, but the authors
should be aware this diagnostic is not "challenging" for specialists. Moreover, one should use
the name of the disease, e.g., schistosomiasis, and not the name of the agent, e.g., paragonimus
Concerning the epidemiology, no need to list all the possible hosts for Toxocara spp (....include
cats, dogs, foxes, coyotes, and wolves) since others exist (!). Sufficient to wrote "canids and
felids".
In the "Introduction", any clear presentation of the aims of the study was found. Actually finding
that pregnant women have the same well known risk factors than the rest of the population has
strictly no interest. The great question was "Does pregnancy exposes to a greater risk to acquire
toxocariasis or not?" No reply was found in this study.
D - Laboratory test
This section should be abridged. Since the authors used a commercial kit, the full description of
the procedure is superfluous. The text from "In brief, microtiter strip wells...." to "....the samples
are considered negative" should be deleted.
E - Statistical analysis
Based only upon an univariate analysis of the results of the investigated variable, statistical
analysis was not sufficient to assess the relation of the claimed outcome variable (the result
of Toxocara serology) with other variables. Adjustment on age was required, because this
parameter is known to be a confounder. Particularly, the found relation between the frequency
of abortion and the result of Toxocara serology could be not significant.
Following univariate analysis, a multivariate regression analysis had to be carried out. The
logistic model would have included any variable of which the P value was <= 0.25 (I wrote 0.25).
G- Results
For a better comprehension, the results had to be displayed in one or two tables, not in the text.
H - Conclusion
The content is vague and not supported by the results of the study. The risk factors which were
detected are classical in the epidemiology of human toxocariasis and idiosyncrasies were not
detected.
a - What does this sentence mean, concerning the present study?
"In negative cases of Toxocara IgG antibodies, pregnancy follow-up and counseling of pregnant
women is necessary to prevent its subsequent complications"
b - Again
"Considering the sensitivity of the studied group and the health risks of toxocariasis for pregnant
women"
- What does "the sensitivity of the studied group" mean?