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埃塞俄比亚南部 Hawassa 大学综合专科医院和 Yirgalem 综合医院产前门诊孕妇中弓形虫的血清流行率。

Seroprevalence of Toxoplasma gondii among pregnant women attending antenatal clinics at Hawassa University comprehensive specialized and Yirgalem General Hospitals, in Southern Ethiopia.

机构信息

College of Medicine and Health Sciences, School of Medical Laboratory Science, Hawassa University, P.O. Box.1560, Hawassa, Ethiopia.

出版信息

BMC Infect Dis. 2019 Dec 16;19(1):1056. doi: 10.1186/s12879-019-4694-8.

Abstract

BACKGROUND

Toxoplasmosis is caused by infection with the protozoan parasite Toxoplasma gondii. It is acquired by consumption of raw or undercooked meat containing tissue cyst, food or water contaminated with oocyst and congenital infection through the placenta leading to serious congenital abnormalities in the fetus like miscarriage, stillbirth, intrauterine death and neurologic defects. Therefore; this study was aimed to determine the prevalence of toxoplasmosis infection and its possible risk factors associated with pregnant women attending antenatal clinics in Hawassa and Yiregalem Hospitals, Southern Ethiopia.

METHODS

A hospital-based cross-sectional study was conducted from December 2016 to May 2017. The study was done in antenatal care clinics of Hawassa and Yiregalem Hospitals in Southern, Ethiopia. Five hundred pregnant women were interviewed with a pretested structured questionnaire to collect risk factors and socio-demographic data. Blood samples were collected and serum was separated and tested for anti- Toxoplasma gondii antibodies using ELISA (Enzyme-linked Immunosorbent Assay). Data were analyzed using SPSS version 20 statistical software. The risk factors were tested for significance using Bivariate and multivariate analysis. P-value < 0.05 was considered statistically significant.

RESULTS

The weighted prevalence of this study was 81.8% for the anti- Toxoplasma gondii antibody. Almost all participants (99.6%) had no information about the disease. A significant association was observed between seroprevalence and contact with domestic cats (OR = 1.206, 95% CI (1.627-2.206, P = 0.043), consumption of raw meat (OR = 0.848, 95% CI: 1.517-2.941, P = 0.019) and unpasteurized milk (OR = 0.871, 95% CI 1.531-2.221, P = 0.032). A significant association was not observed between seroprevalence and age, history of abortion, and blood transfusion.

CONCLUSIONS

The findings of this study demonstrated a relatively higher prevalence of seropositivity than studies reported from other countries. Existence of domestic cats at home, consumption of undercooked meat and unpasteurized milk were identified as risk factors for T. gondii infection. Therefore, a health education program to increase the mother's knowledge about toxoplasmosis towards avoiding eating undercooked meat, contact with cats and consumption of unpasteurized milk during pregnancy is recommended. Furthermore, our results suggested that the implementation of newborn screening and follow-up testing can lead to reducing of toxoplasmosis associated complications.

摘要

背景

弓形虫病是由原生动物寄生虫弓形虫感染引起的。它通过食用含有组织囊肿的生肉或未煮熟的肉、受卵囊污染的食物或水以及通过胎盘的先天性感染获得,导致胎儿出现严重的先天性异常,如流产、死产、宫内死亡和神经缺陷。因此,本研究旨在确定感染弓形虫病的流行率及其与埃塞俄比亚南部 Hawassa 和 Yiregalem 医院产前诊所就诊的孕妇相关的可能危险因素。

方法

这是一项 2016 年 12 月至 2017 年 5 月期间在埃塞俄比亚南部 Hawassa 和 Yiregalem 医院进行的基于医院的横断面研究。对 500 名孕妇进行了访谈,使用预测试的结构化问卷收集了危险因素和社会人口学数据。采集血样并分离血清,使用 ELISA(酶联免疫吸附试验)检测抗弓形虫抗体。使用 SPSS 版本 20 统计软件进行数据分析。使用双变量和多变量分析测试危险因素的显著性。P 值<0.05 被认为具有统计学意义。

结果

本研究的加权患病率为 81.8%,抗弓形虫抗体阳性。几乎所有参与者(99.6%)都不知道这种疾病。血清阳性率与接触家猫(OR=1.206,95%CI(1.627-2.206,P=0.043))、食用生肉(OR=0.848,95%CI:1.517-2.941,P=0.019)和未经巴氏消毒的牛奶(OR=0.871,95%CI 1.531-2.221,P=0.032)之间存在显著关联。血清阳性率与年龄、流产史和输血之间无显著关联。

结论

本研究的结果表明,与来自其他国家的研究相比,血清阳性率相对较高。家中有猫、食用未煮熟的肉和未经过巴氏消毒的牛奶被确定为 T. gondii 感染的危险因素。因此,建议开展一项健康教育计划,提高母亲对弓形虫病的认识,避免在怀孕期间食用未煮熟的肉、接触猫和饮用未经巴氏消毒的牛奶。此外,我们的结果表明,实施新生儿筛查和随访检测可以减少与弓形虫病相关的并发症。

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