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[哈塔伊孕妇弓形虫病的年龄相关患病率:基于模型的估计]

[Age-related prevalence of toxoplasmosis among pregnant women in Hatay: Estimation depending on model].

作者信息

Çetin Meryem, Çetin Şirin

机构信息

Mustafa Kemal University Faculty of Medicine, Department of Medical Microbiology, Hatay, Turkey.

Ondokuz Mayis University Faculty of Medicine, Department of Biostatistics, Samsun, Turkey.

出版信息

Mikrobiyol Bul. 2017 Oct;51(4):361-369. doi: 10.5578/mb.57569.

Abstract

Toxoplasmosis, caused by the obligate intracellular protozoan Toxoplasma gondii, is a common parasitic infection affecting approximately one-third of the world population. T.gondii infections are usually acquired by ingesting raw or insufficiently cooked meat and from unwashed fruits and vegetables contaminated with soil or water with cat feces. Primary infection acquired during pregnancy can cause severe congenital abnormalities in the fetus such as neurologic and ocular malformations, abortion, or stillbirth according to the degree of infection. The aim of this study was to estimate the prevalence and rate of seroconversion of T.gondii IgG antibodies in a selected population of pregnant women in Hatay by using a mathematical model. T.gondii-specific serological screening test results of 11.564 pregnant women who have attended the Private Antakya Mosaic Obstetrics and Gynecology Hospital between 01.04.2009 and 31.04.2016 were analysed in the study. The prevalence of T.gondii-specific IgG antibodies in the studied population were found as 48.70% (95% CI, 0.48-0.50). The prevalence of T.gondii-specific IgG antibodies were increased linearly with age in our study population. The relationship between age and prevalence was statistically significant (p< 0.001). The age-specific rate of seroconversion was estimated as 0.8% for T.gondii infection in pregnant women. It was observed that the rate of T.gondii-specific IgG antibodies decreased from 55.12% (95% Cl, 0.52-0.57) detected in 2009 to 42.22% (95% Cl, 0.37-0.46) in 2016. The estimated number of cases carrying the risk of primer T.gondii infection was calculated as 69 in the study population. Our results have suggested that the prevalence of T.gondii-specific antibodies is high among pregnant women in Hatay. Early maternal diagnosis and treatment methods may reduce the risk of transplacental transmission during pregnancy. The on time diagnosis can only be achieved with prenatal serological screening. The knowledge of the incidence and prevalence of toxoplasma infection in pregnant women plays a crucial role in estimating the burden of the disease and evaluating the effectiveness of the public health protection policies including screening programmes. Expanding of training activities, drawing attention to hygiene, taking nutritional precautions and increasing awareness of toxoplasmosis in pregnant women are important to prevent congenital toxoplasmosis or minimize the disease.

摘要

弓形虫病由专性细胞内原生动物刚地弓形虫引起,是一种常见的寄生虫感染,影响着全球约三分之一的人口。刚地弓形虫感染通常是通过摄入生的或未充分煮熟的肉类,以及食用被猫粪便污染的土壤或水所污染的未清洗水果和蔬菜而获得。孕期初次感染根据感染程度可导致胎儿出现严重的先天性异常,如神经和眼部畸形、流产或死产。本研究的目的是通过数学模型估计哈塔伊选定孕妇群体中刚地弓形虫IgG抗体的流行率和血清转化率。本研究分析了2009年4月1日至2016年4月31日期间在安塔基亚私人马赛克妇产科医院就诊的11564名孕妇的刚地弓形虫特异性血清学筛查检测结果。研究人群中刚地弓形虫特异性IgG抗体的流行率为48.70%(95%可信区间,0.48 - 0.50)。在我们研究人群中,刚地弓形虫特异性IgG抗体的流行率随年龄呈线性增加。年龄与流行率之间的关系具有统计学意义(p < 0.001)。孕妇刚地弓形虫感染的年龄特异性血清转化率估计为0.8%。观察到刚地弓形虫特异性IgG抗体的比例从2009年检测到的55.12%(95%可信区间,0.52 - 0.57)降至2016年的42.22%(95%可信区间,0.37 - 0.46)。研究人群中携带初次刚地弓形虫感染风险的估计病例数计算为69例。我们的结果表明,哈塔伊孕妇中刚地弓形虫特异性抗体的流行率很高。早期的母体诊断和治疗方法可能会降低孕期经胎盘传播的风险。只有通过产前血清学筛查才能实现及时诊断。了解孕妇弓形虫感染的发病率和流行率对于估计疾病负担以及评估包括筛查项目在内的公共卫生保护政策的有效性起着至关重要的作用。扩大培训活动、关注卫生、采取营养预防措施以及提高孕妇对弓形虫病的认识对于预防先天性弓形虫病或使疾病最小化很重要。

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