Jones J L, Dietz V J, Power M, Lopez A, Wilson M, Navin T R, Gibbs R, Schulkin J
Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA.
Infect Dis Obstet Gynecol. 2001;9(1):23-31. doi: 10.1155/S1064744901000059.
Although the incidence of toxoplasmosis is low in the United States, up to 6000 congenital cases occur annually. In September 1998, the Centers for Disease Control and Prevention held a conference about toxoplasmosis; participants recommended a survey of the toxoplasmosis-related knowledge and practices of obstetrician-gynecologists and the development of professional educational materials for them.
In the fall of 1999, surveys were mailed to a 2% random sample of American College of Obstetricians and Gynecologists (ACOG) members and to a demographically representative group of ACOG members known as the Collaborative Ambulatory Research Network (CARN). Responses were not significantly different for the random and CARN groups for most questions (p value shown when different).
Among 768 US practicing ACOG members surveyed, 364 (47%) responded. Seven per cent (CARN 10%, random 5%) had diagnosed one or more case(s) of acute toxoplasmosis in the past year. Respondents were well-informed about how to prevent toxoplasmosis. However, only 12% (CARN 11%, random 12%) indicated that a positive Toxoplasma IgM test might be a false-positive result, and only 11% (CARN 14%, random 9%) were aware that the Food and Drug Administration sent an advisory to all ACOG members in 1997 stating that some Toxoplasma IgM test kits have high false-positive rates. Most of those surveyed (CARN 70%, random 59%; chi2 p < 0.05) were opposed to universal screening of pregnant women.
Many US obstetrician-gynecologists will encounter acute toxoplasmosis during their careers, but they are frequently uncertain about interpretation of the laboratory tests for the disease. Most would not recommend universal screening of pregnant women.
尽管美国弓形虫病的发病率较低,但每年仍有多达6000例先天性病例发生。1998年9月,疾病控制与预防中心召开了一次关于弓形虫病的会议;与会者建议对妇产科医生有关弓形虫病的知识和做法进行调查,并为他们开发专业教育材料。
1999年秋季,调查问卷被邮寄给美国妇产科医师学会(ACOG)成员的2%随机样本以及一个在人口统计学上具有代表性的ACOG成员群体,即协作门诊研究网络(CARN)。对于大多数问题,随机组和CARN组的回答没有显著差异(如有不同,显示p值)。
在接受调查的768名美国执业ACOG成员中,364人(47%)做出了回应。7%(CARN为10%,随机组为5%)在过去一年中诊断出一例或多例急性弓形虫病。受访者对如何预防弓形虫病了解充分。然而,只有12%(CARN为11%,随机组为12%)表示弓形虫IgM检测呈阳性可能是假阳性结果,只有11%(CARN为14%,随机组为9%)知道食品药品监督管理局在1997年向所有ACOG成员发出了一份咨询意见,指出一些弓形虫IgM检测试剂盒有较高的假阳性率。大多数受访者(CARN为70%,随机组为59%;卡方检验p<0.05)反对对孕妇进行普遍筛查。
许多美国妇产科医生在其职业生涯中会遇到急性弓形虫病,但他们对该病实验室检测结果的解读常常不确定。大多数人不建议对孕妇进行普遍筛查。