一项关于波兰孕妇弓形虫病知识的多中心调查（TOWER 研究）。
A multicenter survey on toxoplasmosis knowledge among pregnant women in Poland (the TOWER study).
机构信息
Department of Emergency Medical Service, Laboratory of Experimental Medicine and Innovative Technology, Wroclaw Medical University, Wroclaw, Poland.
Faculty of Medicine, Lazarski University, 43 Swieradowska Str., 02-662, Warsaw, Poland.
出版信息
BMC Pregnancy Childbirth. 2018 Oct 3;18(1):389. doi: 10.1186/s12884-018-2031-7.
BACKGROUND
The seroprevalence of Toxoplasma gondii ranges widely in different areas of the world and different populations. Although toxoplasmosis is typically benign and asymptomatic, it induces major complications in immunocompromised individuals and during pregnancy. Prevention of maternal primary infection constitutes the major tool for avoiding congenital T. gondii infections and toxoplasmosis complications. The preventive measures depend on the women's knowledge about toxoplasmosis. The aim of the study was to assess the knowledge on toxoplasmosis among pregnant women in Poland.
METHODS
The study was conducted between October 2016 and January 2017 in 3 Polish cities. During a visit in a hospital outpatient clinic, pregnant women aged > 16 years fulfilled a previously validated questionnaire. The questions concerned personal data (age, parity, educational level, place of residence), toxoplasmosis knowledge (etiology, routes of transmission, symptoms, sequelae), and sources consulted to collect information.
RESULTS
Overall, 465 pregnant women participated in the survey; 439 (94.4%) were aware of toxoplasmosis. Toxoplasmosis was perceived as a zoonotic disease by 77.4%, as a parasitic disease by 41.7%, as a disease transmitted through poor hand hygiene by 8.6%, as a childhood illness by 4%, and as a congenital disease by 0.4%. Regarding the transmission route, 84.5% of women pointed at a domestic cat, 46.7% at eating raw or undercooked meat. The total of 84.3% did not know toxoplasmosis symptoms, and 12.0% stated that they did not present the symptoms. In multivariate analysis, younger age (OR, 2.74; 95% CI, 1.67-4.49; p < 0.001), city residence (OR, 13.45; 95% CI, 3.12-57.89; p < 0.003), and higher education level (OR, 6.81; 95% CI, 3.69-12.59; p < 0.001) were significantly associated with better knowledge of toxoplasmosis, and the number of children (OR, 0.32; 95% CI, 0.22-0.48; p < 0.001) - with higher knowledge of the symptoms.
CONCLUSIONS
Among pregnant women in Poland, the basic knowledge on toxoplasmosis is very high (94.4%). Younger age, city residence, higher education level, and the number of children turned out significantly associated with better knowledge of T. gondii and toxoplasmosis symptoms.
背景
刚地弓形虫的血清流行率在世界不同地区和不同人群中差异很大。虽然弓形虫病通常是良性且无症状的，但它会在免疫功能低下的个体和怀孕期间引起严重并发症。预防母体初次感染是避免先天性弓形虫感染和弓形虫病并发症的主要手段。预防措施取决于妇女对弓形虫病的认识。本研究的目的是评估波兰孕妇对弓形虫病的认识。
方法
本研究于 2016 年 10 月至 2017 年 1 月在波兰的 3 个城市进行。在医院门诊就诊期间，年龄大于 16 岁的孕妇填写了一份预先验证的问卷。问题涉及个人数据（年龄、产次、教育水平、居住地）、弓形虫病知识（病因、传播途径、症状、后遗症）以及收集信息的来源。
结果
共有 465 名孕妇参与了调查；439 名（94.4%）孕妇知晓弓形虫病。77.4%的孕妇认为弓形虫病是一种动物源性疾病，41.7%的孕妇认为它是一种寄生虫病，8.6%的孕妇认为它是通过不良手部卫生传播的疾病，4%的孕妇认为它是一种儿童疾病，0.4%的孕妇认为它是一种先天性疾病。关于传播途径，84.5%的女性指向家猫，46.7%的女性指向食用生的或未煮熟的肉。84.3%的人不知道弓形虫病的症状，12.0%的人表示没有出现症状。多变量分析显示，年龄较小（OR，2.74；95%CI，1.67-4.49；p<0.001）、城市居住（OR，13.45；95%CI，3.12-57.89；p<0.003）和较高的教育水平（OR，6.81；95%CI，3.69-12.59；p<0.001）与更好的弓形虫病知识显著相关，而孩子的数量（OR，0.32；95%CI，0.22-0.48；p<0.001）与更高的症状知识相关。
结论
在波兰孕妇中，对弓形虫病的基本知识非常高（94.4%）。年龄较小、城市居住、较高的教育水平和孩子的数量与更好的刚地弓形虫病和弓形虫病症状知识显著相关。
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