Toxocariasis, risk and protective factors, and mental health difficulties in early childhood: a comparison of marginalised Roma communities and the majority population.

Toxocariasis is a parasitic infection that poses significant health risks to children, particularly in marginalised populations with limited access to sanitation and healthcare. This study aimed to compare the occurrence of toxocariasis in early childhood between a group of children from the Slovak majority population and from marginalised Roma communities (MRCs), explore potential risk and protective factors and the association with mental health difficulties in early childhood. Cross-sectional data were obtained from mothers, and blood samples of their children aged 14-21 months were collected during the first wave of the longitudinal RomaREACH study. A total of 88 blood samples from children were analysed: 49 children from the Slovak Majority population and 39 from MRCs. Anti-Toxocara canis IgG antibodies were detected in serum samples using an enzyme-linked immunosorbent assay (ELISA). Though it was not statistically significant, seropositivity for Toxocara canis was more often observed in children from MRCs (35.9%) than in the majority population (20.4%). The absence of running water in households significantly increases the risk of Toxocara infection in children, whereas a longer duration of breastfeeding decreases it. Children seropositive for Toxocara canis showed higher levels of early mental health difficulties even when controlled for MRC residence. These results indicate the need for integrated public health interventions targeting parasitic infections in susceptible populations. Improving access to sanitation, promoting breastfeeding, and strengthening the preventive and educational role of early childhood health services are critical strategies to reduce the risk of exposure to Toxocara spp. eggs and mitigate its potential impact on child health and development.