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巴西东南部青少年和成年孕妇抗弓蛔虫抗体的血清学调查及危险因素分析。

Serosurvey of anti-Toxocara antibodies and risk factors in adolescent and adult pregnant women of southeastern Brazil.

机构信息

Graduate College in Animal Sciences, University of Western São Paulo (UNOESTE), Presidente Prudente, SP, Brazil.

Institute of Tropical Medicine of São Paulo, University of São Paulo, SP, Brazil.

出版信息

PLoS Negl Trop Dis. 2021 Aug 4;15(8):e0009571. doi: 10.1371/journal.pntd.0009571. eCollection 2021 Aug.

Abstract

Toxocariasis is worldwide endemic parasitic anthropozoonosis with high risk to those in in vulnerable populations and particularly during pregnancy and childhood. Although the prevalence of anti-Toxocara spp. antibodies has been extensively studied, risk factors of pregnant women of different ages remains to be established. This study was designed to i) assess the presence of anti-Toxocara spp. antibodies in pregnant women that presented to the public health system in a city of southeastern Brazil, and ii) determine the risk factors for toxocariasis in adolescent and adult pregnant women. This cross-sectional study included 280 pregnant women (71 aged up to and including 17 years [adolescents] and 209 aged 18 years and older [adults]). Pregnant women voluntarily agreed to complete a socioeconomic questionnaire and provide serum samples. Anti-Toxocara IgG antibodies were screened by Enzyme-Linked Immunosorbent Assay (ELISA). Univariable and multivariable logistic regression models were performed to assess the risks for toxocariasis. Overall, 20.7% of pregnant women were seropositive (33.8% of adolescents and 16.3% of adults). Prevalence in pregnant adolescents was 2.6-fold higher than in adults (Odds ration [OR]: 2.63; 95% CI: 1.42-4.86, p = 0.003). Multivariate analysis revealed that contact with soil (p = 0.01; OR = 4.76) and being in the first trimester of pregnancy (p = 0.03; OR = 0.17) had significantly greater risk of toxocariasis for adolescents, and attainment of elementary through middle school education level (p = 0.05; OR = 8.33) was a risk factor in adult pregnant women. Toxocariasis is likely underreported and neglected in adolescent pregnant women; this age group should always be monitored for toxocariasis and correspondent clinical signs, particularly at late pregnancy.

摘要

弓蛔虫病是一种全球性流行的寄生虫性人畜共患病,高危人群为弱势群体,尤其是孕妇和儿童。尽管已经广泛研究了抗弓蛔虫属抗体的流行情况,但不同年龄段孕妇的危险因素仍有待确定。本研究旨在:i)评估巴西东南部某城市公共卫生系统就诊的孕妇中抗弓蛔虫属抗体的存在情况;ii)确定青少年和成年孕妇感染弓蛔虫病的危险因素。本横断面研究纳入了 280 名孕妇(71 名年龄在 17 岁及以下的青少年,209 名年龄在 18 岁及以上的成年孕妇)。孕妇自愿同意填写一份社会经济调查问卷并提供血清样本。采用酶联免疫吸附试验(ELISA)检测抗弓蛔虫 IgG 抗体。采用单变量和多变量逻辑回归模型评估感染弓蛔虫病的风险。总体而言,20.7%的孕妇呈血清阳性(青少年组为 33.8%,成年组为 16.3%)。青少年孕妇的患病率是成年孕妇的 2.6 倍(优势比 [OR]:2.63;95%置信区间 [CI]:1.42-4.86,p = 0.003)。多变量分析显示,接触土壤(p = 0.01;OR = 4.76)和妊娠早期(p = 0.03;OR = 0.17)与青少年感染弓蛔虫病的风险显著增加相关,而完成小学至中学教育水平(p = 0.05;OR = 8.33)是成年孕妇的一个危险因素。青少年孕妇的弓蛔虫病可能报告不足且被忽视;该年龄段孕妇应始终监测弓蛔虫病及其相关临床症状,尤其是在妊娠晚期。

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