@misc{salem_salem_ismail_abdelrazek_ghamdi_2022, 
  title={Toxoplasma and Toxocara Seroprevalence in children and adolescents with Juvenile Idiopathic Arthritis and Its relation to disease activity and Type of Therapies: Should We Screen Before Treatment?}, 
  DOI={10.21203/rs.3.rs-1436328/v1}, 
  abstractNote={<jats:title>Abstract</jats:title>
        <jats:p>Background
 In children, juvenile idiopathic arthritis (JIA) is the most frequently encountered autoimmune rheumatic disease. A relationship between <jats:italic>Toxoplasma gondii</jats:italic> and <jats:italic>Toxocara</jats:italic> spp. infections and a variety of autoimmune diseases has been reported. However, there are no studies on the epidemiology and impact of <jats:italic>Toxoplasma</jats:italic> and <jats:italic>Toxocara</jats:italic> infections in juvenile idiopathic arthritis.
Aim
 To estimate the seroprevalence of <jats:italic>Toxoplasma gondii</jats:italic> (<jats:italic>T. gondii)</jats:italic> and <jats:italic>Toxocara</jats:italic> in JIA children and adolescents and assess its relation to the disease activity and type of therapy.
Methods
 A case-control study was designed to estimate the prevalence and risk factors of <jats:italic>T. gondii</jats:italic> and <jats:italic>Toxocara</jats:italic> infection in 43 JIA patients in comparison to 50 healthy controls using enzyme-linked immunosorbent assay.
Results
 There was a significant difference between JIA patients and healthy control subjects as regard anti-T. gondii IgG seroprevalence (P = 0.02) and a non-significant difference in Toxocara seropositivity (P = 0.41). Demographic factors did not affect <jats:italic>T. gondii</jats:italic> and <jats:italic>Toxocara</jats:italic> infection prevalence. Seropositive anti-<jats:italic>T. gondii</jats:italic> IgG cases had a significantly higher disease activity score (JADAS)-27 than seronegative anti-<jats:italic>T. gondii</jats:italic> IgG cases (p = 0.05); with no significant differences regarding anti-<jats:italic>Toxocara</jats:italic> IgG (p &gt; 0.05). The highest <jats:italic>T. gondii</jats:italic> infection seropositivity rate was detected in patients with extended oligoarthritis (4 cases in seropositive vs. two among seronegative, p = 0.34). There was a significant association between immunosuppressive including biological therapies, and <jats:italic>T. gondii</jats:italic> IgG seropositivity (p &lt; 0.05).
Conclusions
 The findings of this study support a link between <jats:italic>T. gondii</jats:italic> infection and JIA, disease activity score, and biologic Disease-modifying antirheumatic drugs (DMARDs) therapies. As a result, a recommendation for screening tests for <jats:italic>T. gondii</jats:italic> infection among JIA patients is crucial prior to and during commencing biological therapies and closely monitoring early signs of infection.</jats:p>}, 
  publisher={Research Square Platform LLC}, 
  author={Salem, Doaa A. and Salem, Nanees A. and Ismail, Amira and Abdelrazek, Eman and ghamdi, Jameel Al}, 
  year={2022}, 
  month={Mar}
  }