Paul Eliakimu, Kiwelu Ireen, Mmbaga Blandina, Nazareth Rebeka, Sabuni Elias, Maro Athanasia, Ndaro Arnold, Halliday Jo E B, Chilongola Jaffu
1Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania.
Kilimanjaro Clinical Research Institute, P.O. Box 2236, Moshi, Tanzania.
Trop Med Health. 2018 Nov 19;46:39. doi: 10.1186/s41182-018-0122-9. eCollection 2018.
Acute infection during pregnancy represents a risk for congenital disease, especially among women without previous exposure to infection. There is, however, a paucity of information about the epidemiology of infection in pregnant women in Tanzania. This study aimed to determine the seroprevalence of infection and associated demographic, clinical, and behavioral risk factors in pregnant women attending ante-natal clinic (ANC) at Kilimanjaro Christian Medical Center (KCMC), a referral medical center in Northern Tanzania.
A hospital-based cross-sectional study was carried out from 1 February to 30 April 2017. Data on maternal demographic characteristics, obstetric history, knowledge, and practices related to infection were collected from 254 pregnant women attending antenatal care at KCMC. A sample of 4 mL of blood was collected from each participant and sera prepared from each sample. Serum samples were tested for the presence of specific IgG and IgM antibodies by indirect Enzyme-Linked Immunosorbent Assay (ELISA). DNA was extracted from whole blood for polymerase chain reaction (PCR) testing, targeting the DNA sequence coding for the Internal Transcribed Spacer 1 (ITS1).
The overall seroprevalence, including both IgM- and IgG-positive individuals, was 44.5%. Of the 254 tested women, 102 and 23 were seropositive for -specific IgG and IgM antibodies respectively and 113 individuals had antibodies of either or both classes. All IgM-positive samples were also tested by PCR, and all were negative. The majority (90%) of the women surveyed had never heard about toxoplasmosis. Consumption of raw vegetables [aOR = 0. 344; 95% CI 0.151-0.784; = 0.011] and having regular contact with soil [aOR = 0.482; 95% CI 0.268-0.8681; = 0.015] were both associated with antibody status. Inverse relationships with probability of exposure were observed, such that these practices were associated with reduced probability of antibody detection.
Based on serology results, we report widespread exposure to infection among pregnant women attending ANC in KCMC. The complex interaction of risk factors for infection needs to be studied in larger longitudinal studies.
孕期急性感染会引发先天性疾病风险,尤其是对于既往未接触过感染的女性。然而,坦桑尼亚孕妇感染的流行病学信息匮乏。本研究旨在确定在坦桑尼亚北部的转诊医疗中心乞力马扎罗基督教医疗中心(KCMC)产前检查门诊就诊的孕妇中感染的血清阳性率以及相关的人口统计学、临床和行为风险因素。
2017年2月1日至4月30日开展了一项基于医院的横断面研究。从在KCMC接受产前护理的254名孕妇中收集了产妇人口统计学特征、产科病史、与感染相关的知识和行为的数据。从每位参与者采集4毫升血液样本,并从每个样本中制备血清。通过间接酶联免疫吸附测定(ELISA)检测血清样本中特异性IgG和IgM抗体的存在情况。从全血中提取DNA用于聚合酶链反应(PCR)检测,以编码内转录间隔区1(ITS1)的DNA序列为靶点。
总体血清阳性率(包括IgM和IgG阳性个体)为44.5%。在254名接受检测的女性中,分别有102名和23名女性针对特异性IgG和IgM抗体呈血清阳性,113名个体具有其中一类或两类抗体。所有IgM阳性样本也通过PCR进行了检测,结果均为阴性。大多数(90%)接受调查的女性从未听说过弓形虫病。食用生蔬菜 [调整后比值比(aOR)= 0.344;95%置信区间(CI)0.151 - 0.784;P = 0.011] 和经常接触土壤 [aOR = 0.482;95% CI 0.268 - 0.8681;P = 0.015] 均与抗体状态相关。观察到与感染暴露概率呈负相关关系,即这些行为与抗体检测概率降低相关。
基于血清学结果,我们报告在KCMC产前检查门诊就诊的孕妇中广泛存在感染暴露情况。感染风险因素的复杂相互作用需要在更大规模的纵向研究中进行探究。