斯里兰卡孕妇弓形虫病血清流行率及弓形虫感染的危险因素：一项横断面研究
Seroprevalence of toxoplasmosis and risk factors of Toxoplasma gondii infection among pregnant women in Sri Lanka: a cross sectional study.
作者信息
Iddawela Devika, Vithana Sanura Malinda Pallegoda, Ratnayake Chathura
机构信息
Department of Parasitology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
出版信息
BMC Public Health. 2017 Dec 4;17(1):930. doi: 10.1186/s12889-017-4941-0.
BACKGROUND
Toxoplasma gondii is an intracellular protozoan infecting humans and animals. Infection in adults usually causes mild disease but greater importance lies in preventing transplacental transmission which can cause major foetal anomalies and is vital to identify infection in pregnancy. Research on this regard in Sri Lanka is scarce and would be beneficial in developing antenatal care strategies for improved foetal outcome.
METHODS
A random sample of 536 pregnant women attending antenatal care in Teaching Hospital Peradeniya from 2010 to 2013 was recruited for this study. Blood samples were tested for Toxoplasma gondii IgG and IgM antibodies from the participants by using a commercial ELISA kit with a cut-off OD value of >1 and a structured questionnaire was used to identify the exposure to risk. Bivariate analysis using the Chi Square test was used to calculate associations between documented risk factors and seropositivity and a p value of <0.05 was taken as significant.
RESULTS
Among the participants 160 (29.9%) were positive for T. gondii IgG antibodies and 2 (0.37%) were IgM positive. The seroprevalence in the first, second and third trimesters were 30.4%, 30.6% and 26.1% respectively. Of the risk factors studied, preparation and selling raw meat (p = 0.05) and household gardening (p = 0.01) were significant whereas the presence of domesticated cats and dogs, eating locally produced meat or dairy products did not show significant associations.
CONCLUSIONS
Seroprevalence of T. gondii present among pregnant women attending antenatal care in Peradeniya was 29.9% indicating high level of transmission among the study population. However 70.1% of the study population were seronegative and were susceptible to primary acute infection during pregnancy and possible foetal anomalies. Therefore implementing health education especially on the aforementioned risk factors is recommended.
背景
刚地弓形虫是一种感染人类和动物的细胞内原生动物。成人感染通常引起轻微疾病，但更重要的是预防经胎盘传播，这种传播可导致严重的胎儿畸形，因此识别孕期感染至关重要。斯里兰卡对此方面的研究较少，这对于制定改善胎儿结局的产前护理策略将是有益的。
方法
本研究招募了2010年至2013年在佩拉德尼亚教学医院接受产前护理的536名孕妇的随机样本。使用截断光密度值>1的商用酶联免疫吸附测定（ELISA）试剂盒检测参与者血液样本中的刚地弓形虫IgG和IgM抗体，并使用结构化问卷来确定风险暴露情况。采用卡方检验进行双变量分析，以计算记录的风险因素与血清阳性之间的关联，p值<0.05被视为具有显著性。
结果
在参与者中，160人（29.9%）刚地弓形虫IgG抗体呈阳性，2人（0.37%）IgM呈阳性。妊娠第一、第二和第三孕期的血清阳性率分别为30.4%、30.6%和26.1%。在所研究的风险因素中，准备和销售生肉（p = 0.05）以及家庭园艺（p = 0.01）具有显著性，而家中养猫和狗、食用本地生产的肉类或奶制品未显示出显著关联。
结论
在佩拉德尼亚接受产前护理的孕妇中，刚地弓形虫血清阳性率为29.9%，表明研究人群中的传播水平较高。然而，70.1%的研究人群血清学阴性，在孕期易发生原发性急性感染并可能出现胎儿畸形。因此，建议开展健康教育，尤其是针对上述风险因素的教育。
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