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[基于人群的横断面研究对安塔利亚巨细胞病毒血清流行病学的调查及土耳其相关数据综述]

[Investigation of cytomegalovirus seroepidemiology in Antalya with a population-based cross-sectional study and review of related data in Turkey].

作者信息

Ataman Senay, Colak Dilek, Günseren Filiz, Senol Yeşim, Colak Taner, Aktekin Mehmet R, Gültekin Meral

机构信息

Akdeniz Universitesi Tip Fakültesi, Tibbi Mikrobiyoloji Anabilim Dali, Antalya.

出版信息

Mikrobiyol Bul. 2007 Oct;41(4):545-55.

Abstract

Since there are numerous studies on CMV seroprevalence in various groups in Turkey, the number of population based, age-stratified cross-sectional studies which include epidemiological characteristics of the virus are limited. The aim of the study was to investigate the age-stratified seroprevalence and epidemiological characteristics of CMV infection in Antalya (a province located in Mediterranean region of Turkey). Study group was selected by cluster sampling method. The sample size was calculated as 360 subjects (151 male, 209 female; age range: 1-49 years, mean age: 22.5 +/- 14.4 years), with an expected prevalence rate of 80%, at a confidence level of 95% and a sample error less than 5%. With the thought of the presence of maternal antibodies, 0-1 year age group was not included to the study. Serum samples have been screened for CMV-IgG, and those given negative results were also searched for CMV-IgM by a commercial microELISA (Radim, Italy) test. The overall seroprevalence of CMV-IgG was found as 93.6% (337/360) in Antalya municipality and IgM positivity was not detected in CMV-IgG negative sera. An increase in the seroprevalence rates was observed with age (p < 0.001), and the rate was found quite high (93.3%) for the first year of life. The seropositivities in the age groups of 1-6, 7-14 and 14-49 years were detected as 82.1%, 92% and 97.8%, respectively. The seroprevalence rate of 82.1% before the age of seven has rised to 96.8% after that age, and being > or =7 years old was found statistically significant in terms of CMV infection (p < 0.001, OR: 6.635). Ages one and seven were found to be the critical ages for CMV infection in our region. CMV seropositivity was 97.4% in woman at childbearing age (15-49 years). Gender, marital status, education, living area, residence, income, history of sexually transmitted diseases, surgery, blood transfusion and day care attendance did not contribute independently to the seroepidemiology of CMV (p > 0.01). In addition, the data of this study were evaluated and discussed together with the results obtained from the other Turkish studies, as far as accessible. In conclusion, since CMV seroepidemiology in Turkey differs as the socioeconomic changes occur, the changes in CMV serostatus and dire consequences of high seroprevalence rates on public health should be evaluated with prospective, population based studies in further years.

摘要

由于土耳其针对不同人群开展了大量关于巨细胞病毒血清流行率的研究,而基于人群的、按年龄分层的横断面研究数量有限,这些研究应包含该病毒的流行病学特征。本研究旨在调查安塔利亚(土耳其地中海地区的一个省份)按年龄分层的巨细胞病毒感染血清流行率及流行病学特征。研究组采用整群抽样法选取。样本量计算为360名受试者(151名男性,209名女性;年龄范围:1至49岁,平均年龄:22.5±14.4岁),预期流行率为80%,置信水平为95%,抽样误差小于5%。考虑到母体抗体的存在,0至1岁年龄组未纳入本研究。血清样本进行了巨细胞病毒IgG筛查,对结果为阴性的样本还通过商用微酶联免疫吸附测定法(意大利拉迪姆公司)检测了巨细胞病毒IgM。在安塔利亚市,巨细胞病毒IgG的总体血清流行率为93.6%(337/360),在巨细胞病毒IgG阴性血清中未检测到IgM阳性。随着年龄增长,血清流行率上升(p<0.001),且一岁时的流行率相当高(93.3%)。1至6岁、7至14岁和14至49岁年龄组的血清阳性率分别为82.1%、92%和97.8%。七岁前血清流行率为82.1%,七岁后升至96.8%,在巨细胞病毒感染方面,年龄大于或等于7岁具有统计学意义(p<0.001,比值比:6.635)。在我们地区,一岁和七岁被发现是巨细胞病毒感染的关键年龄。育龄期女性(15至49岁)的巨细胞病毒血清阳性率为97.4%。性别、婚姻状况、教育程度、居住地区、住所、收入、性传播疾病史、手术史、输血史和日托出勤情况对巨细胞病毒血清流行病学无独立影响(p>0.01)。此外,本研究的数据与可获取的其他土耳其研究结果一起进行了评估和讨论。总之,由于土耳其的巨细胞病毒血清流行病学随社会经济变化而不同,未来几年应通过前瞻性、基于人群的研究来评估巨细胞病毒血清状态的变化以及高血清流行率对公共卫生的严重后果。

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