Ertug Sema, Okyay Pinar, Turkmen Munevver, Yuksel Hasan
Department of Parasitology, Adnan Menderes University, School of Medicine, Aydin, Turkey.
BMC Public Health. 2005 Jun 15;5:66. doi: 10.1186/1471-2458-5-66.
The aims of the present study were to determine the prevalence of toxoplasmosis in pregnant women at first trimester of their pregnancy and to follow up the seroconversion for next two trimesters, and to identify the risk factors and possible contamination routes in Aydin province, Turkey.
The sample size was calculated as 423 on a prevalence of 50%, d=0.05 at a confidence level of 95% with 10% addition. It was a cross-sectional study with multistage sampling. After a questionnaire applied to the pregnant women, anti-Toxoplasma IgG antibodies were studied with ELISA and IFA, values in conflict with DA test, where IgM antibodies were studied with ELISA and for borderline or positive values of IgM avidity test was used.
The mean age of 389 (92.9%) of pregnant women in the study was 24.28+/-4.56 years, the seroprevalence of anti-Toxoplasma IgG antibodies for toxoplasmosis was 30.1%. Seroprevalence was increased with age (p=0.001) and with drinking water consumption other than bottled water (p=0.042). No significant relations were observed between anti-Toxoplasma IgG antibodies and education level, being native or migrant, abortion history, consumption of meat, vegetable and milk/milk products, personal or kitchen hygiene habits, cat owning at home of the pregnant women. No IgM antibody was detected.
One of every three pregnant women in Aydin was at risk of toxoplasmosis at the first trimester of their pregnancy. Increased seroprevalance with age was a predictable result because of increasing time of exposure. Increased seroprevalence with consumption of municipal and uncontrolled water (well/spring water) supplies was similar with latest epidemiological findings.
本研究的目的是确定妊娠早期孕妇弓形虫病的患病率,并对接下来的两个孕期进行血清转化随访,同时确定土耳其艾登省的危险因素和可能的感染途径。
在患病率为50%、d = 0.05、置信水平为95%且增加10%的情况下,计算样本量为423。这是一项采用多阶段抽样的横断面研究。在对孕妇进行问卷调查后,用酶联免疫吸附测定法(ELISA)和间接荧光抗体法(IFA)检测抗弓形虫IgG抗体,对于与暗视野凝集试验结果冲突的值,用ELISA检测IgM抗体,对于IgM亲和力试验的临界值或阳性值采用相应检测方法。
研究中389名(92.9%)孕妇的平均年龄为24.28±4.56岁,弓形虫病抗弓形虫IgG抗体的血清阳性率为30.1%。血清阳性率随年龄增加而升高(p = 0.001),且与饮用非瓶装水有关(p = 0.042)。未观察到孕妇抗弓形虫IgG抗体与教育水平、是否为本国居民或移民、流产史、肉类、蔬菜及牛奶/奶制品的消费、个人或厨房卫生习惯、家中是否养猫之间存在显著关系。未检测到IgM抗体。
在艾登,每三名孕妇中就有一名在妊娠早期有感染弓形虫病的风险。由于接触时间增加,血清阳性率随年龄增加是可预测的结果。因饮用市政供应的非管控水源(井水/泉水)导致血清阳性率增加,这与最新的流行病学研究结果相似。