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缅甸仰光地区屠宰场工人弓形虫血清流行率及相关感染危险因素:一项横断面研究。

Seroprevalence and associated risk factors of Toxoplasma gondii infection among slaughterhouse workers in Yangon Region, Myanmar: A cross-sectional study.

机构信息

Department of Preventive and Social Medicine, Defence Services Medical Academy, Yangon, Myanmar.

Department of Prevention and Research Development of Hepatitis, AIDS and Other Viral Diseases, Health and Disease Control Unit, Nay Pyi Taw, Myanmar.

出版信息

PLoS One. 2023 Apr 13;18(4):e0284352. doi: 10.1371/journal.pone.0284352. eCollection 2023.

Abstract

BACKGROUND

Toxoplasmosis, having the significant consequences affecting mortality and quality of life, is still prevalent in various places throughout the world. The major gap in surveillance for Toxoplasma gondii infection among high-risk population, slaughterhouse workers, is an obstacle for the effective policies formulation to reduce the burden of toxoplasmosis in Myanmar. Therefore, this study aimed to assess the seroprevalence of toxoplasmosis and associated factors of seropositivity among slaughterhouse workers in Yangon Region, Myanmar.

METHODS

A cross-sectional study that was conducted from June to November 2020 included 139 slaughterhouse workers involving at five main slaughterhouses under Yangon City Development Committee, Myanmar. The presence of IgG and IgM anti-T. gondii antibodies in serum was detected using the OnSite Toxo IgG/IgM Combo Rapid Test. A face-to-face interview was also performed using pretested structured questionnaires to obtain the detail histories: sociodemographic characteristics, level of knowledge, occupational factors, and environmental factors related to T. gondii infection. Bivariate logistic regression was used to determine the factors associated with T. gondii infection.

RESULTS

Of all participants, the overall seroprevalence of anti-T. gondii was 43.9% (95% CI: 35.5-52.5%), of whom 98.4% (95% CI: 91.2-100.0%) were reactive only for IgG antibody and 1.6% (95% CI: 0.0-8.8%) were reactive for IgG and IgM antibodies. The significant factors associated with the seropositivity of T. gondii antibodies were blood transfusion history (OR: 5.74, 95% CI: 1.17-28.09), low level of knowledge (OR: 2.91, 95% CI: 1.46-5.83), contact with animal organs, muscles or blood (OR: 14.29, 95% CI: 1.83-111.51), and animals most frequently slaughtered (cattle) (OR: 3.22, 95% CI: 1.16-8.93).

CONCLUSIONS

A high seroprevalence of toxoplasmosis was detected among slaughterhouse workers in Yangon Region and it raises a significant public health concern. Therefore, providing health education regarding toxoplasmosis, enforcement of personal hygiene practices in workplaces, the establishment of training for occupational hygiene, and commencement of the risk assessment and serological screening for toxoplasmosis are crucial to curtail the prevalence of T. gondii infection among slaughterhouse workers.

摘要

背景

弓形虫病具有显著影响死亡率和生活质量的重要后果,在世界许多地方仍普遍存在。在高危人群(屠宰场工人)中,对刚地弓形虫感染的监测存在重大差距,这是制定有效政策以减轻缅甸弓形虫病负担的障碍。因此,本研究旨在评估仰光地区屠宰场工人的弓形虫病血清流行率及其血清阳性的相关因素。

方法

这是一项 2020 年 6 月至 11 月进行的横断面研究,包括仰光市发展委员会下属的五个主要屠宰场的 139 名屠宰场工人。使用 OnSite Toxo IgG/IgM Combo Rapid Test 检测血清中 IgG 和 IgM 抗弓形虫抗体的存在。还使用预先测试的结构化问卷进行面对面访谈,以获取详细的病史:与 T. gondii 感染相关的社会人口统计学特征、知识水平、职业因素和环境因素。使用二变量逻辑回归来确定与 T. gondii 感染相关的因素。

结果

在所有参与者中,抗弓形虫的总血清流行率为 43.9%(95%CI:35.5-52.5%),其中 98.4%(95%CI:91.2-100.0%)仅对 IgG 抗体呈反应性,而 1.6%(95%CI:0.0-8.8%)对 IgG 和 IgM 抗体呈反应性。与 T. gondii 抗体血清阳性相关的显著因素是输血史(OR:5.74,95%CI:1.17-28.09)、低知识水平(OR:2.91,95%CI:1.46-5.83)、接触动物器官、肌肉或血液(OR:14.29,95%CI:1.83-111.51)和最常屠宰的动物(牛)(OR:3.22,95%CI:1.16-8.93)。

结论

在仰光地区的屠宰场工人中检测到高弓形虫病血清流行率,这引起了重大的公共卫生关注。因此,提供关于弓形虫病的健康教育、在工作场所执行个人卫生实践、建立职业卫生培训、开展弓形虫病风险评估和血清筛查,对于减少屠宰场工人的 T. gondii 感染患病率至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc6d/10101469/1e6b50860260/pone.0284352.g001.jpg

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