Background In children, juvenile idiopathic arthritis (JIA) is the most frequently encountered autoimmune rheumatic disease. A relationship between Toxoplasma gondii and Toxocara spp. infections and a variety of autoimmune diseases has been reported. However, there are no studies on the epidemiology and impact of Toxoplasma and Toxocara infections in juvenile idiopathic arthritis. Aim To estimate the seroprevalence of Toxoplasma gondii (T. gondii) and Toxocara in JIA children and adolescents

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... 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 T. gondii and Toxocara 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 T. gondii and Toxocara infection prevalence. Seropositive anti-T. gondii IgG cases had a significantly higher disease activity score (JADAS)-27 than seronegative anti-T. gondii IgG cases (p = 0.05); with no significant differences regarding anti-Toxocara IgG (p > 0.05). The highest T. gondii 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 T. gondii IgG seropositivity (p < 0.05). Conclusions The findings of this study support a link between T. gondii infection and JIA, disease activity score, and biologic Disease-modifying antirheumatic drugs (DMARDs) therapies. As a result, a recommendation for screening tests for T. gondii infection among JIA patients is crucial prior to and during commencing biological therapies and closely monitoring early signs of infection.