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越南北部孕妇弓形虫病的血清流行病学状况和危险因素。

Sero-epidemiological status and risk factors of toxoplasmosis in pregnant women in Northern Vietnam.

机构信息

Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820, Merelbeke, Belgium.

Department of Biomedical Sciences, Institute of Tropical Medicine (ITM), Nationalestraat 155, B-2000, Antwerp, Belgium.

出版信息

BMC Infect Dis. 2019 Apr 18;19(1):329. doi: 10.1186/s12879-019-3885-7.

DOI:10.1186/s12879-019-3885-7
PMID:30999869
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6471880/
Abstract

BACKGROUND

In Vietnam, few studies have determined the epidemiological status of toxoplasmosis in pregnant women and no routine prenatal screening is in place. This study was conducted to evaluate the seroprevalence of this zoonotic parasitic infection in pregnant women in Northern Vietnam and to assess the association with awareness, risk factors and congenital toxoplasmosis.

METHODS

Approximately 800 pregnant women were included in the study from two hospitals, one in Hanoi and one in Thai Binh province, which is known to have a dense cat population. Serological immunoglobulin G (IgG) and immunoglobulin M (IgM) detection was performed to estimate the seroprevalence of toxoplasmosis and sero-incidence of maternal and congenital toxoplasmosis. In addition, a survey was conducted about awareness, clinical history, presentation of signs and symptoms relating to toxoplasmosis and to detect biologically plausible and socio-demographic risk factors associated with toxoplasmosis. Associations with seroprevalence were assessed using univariable and multivariable analysis.

RESULTS

The mean IgG seroprevalence after the full diagnostic process was 4.5% (95% confidence interval(CI): 2.7-7.0) and 5.8% (95% CI: 3.7-8.6) in Hanoi and Thai Binh hospital, respectively, and included one seroconversion diagnosed in Thai Binh hospital. Only 2.0% of the pregnant women in Hanoi hospital and 3.3% in Thai Binh hospital had heard about toxoplasmosis before this study.

CONCLUSION

Since the percentage of seronegative, and thus susceptible, pregnant women was high and the awareness was low, we suggest to distribute information about toxoplasmosis and its prevention among women of child bearing age. Furthermore, future studies are recommended to investigate why such a low seroprevalence was seen in pregnant women in Northern Vietnam compared to other countries in South East Asia and globally.

摘要

背景

在越南,很少有研究确定孕妇弓形虫病的流行病学状况,也没有常规的产前筛查。本研究旨在评估越南北部孕妇这种人畜共患寄生虫感染的血清流行率,并评估其与意识、危险因素和先天性弓形虫病的关系。

方法

从两家医院(一家位于河内,一家位于泰宾省)招募了大约 800 名孕妇。该省以猫群密集而闻名。进行血清学 IgG(免疫球蛋白 G)和 IgM(免疫球蛋白 M)检测,以评估弓形虫病的血清流行率和母婴先天性弓形虫病的血清发生率。此外,还进行了一项关于意识、临床病史、与弓形虫病相关的体征和症状表现以及检测与弓形虫病相关的生物学合理和社会人口学危险因素的调查。使用单变量和多变量分析评估与血清流行率的关联。

结果

经过完整的诊断过程,平均 IgG 血清阳性率分别为 4.5%(95%置信区间[CI]:2.7-7.0)和 5.8%(95% CI:3.7-8.6),分别在河内和泰宾医院,包括在泰宾医院诊断的一次血清转换。只有 2.0%的河内医院孕妇和 3.3%的泰宾医院孕妇在本研究之前听说过弓形虫病。

结论

由于血清阴性(即易感染)孕妇的比例较高,且意识较低,因此我们建议在育龄妇女中传播有关弓形虫病及其预防的信息。此外,建议未来的研究调查为什么越南北部孕妇的血清阳性率如此之低,与东南亚其他国家和全球相比。