加纳库马西地区级医院的横断面研究：孕妇的感染血清流行率和危险因素。
Seroprevalence and Risk Factors of Infection among Pregnant Women in Kumasi: A Cross-Sectional Study at a District-Level Hospital, Ghana.
机构信息
Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
出版信息
Infect Dis Obstet Gynecol. 2021 Apr 2;2021:6670219. doi: 10.1155/2021/6670219. eCollection 2021.
BACKGROUND
This study investigated the prevalence and risk factors of infection among pregnant women in a district-level hospital in Ghana and compared the diagnostic performance of the rapid diagnostic test (RDT) and enzyme-linked immunosorbent assay (ELISA) for . diagnosis.
METHOD
This cross-sectional study included 400 consecutive consenting women in their first-trimester stage of pregnancy. A validated well-structured closed-ended questionnaire was used to collect sociodemographic data and possible risk factors of each participant. Blood samples were collected for analysis of . IgG and IgM using the commercial ELISA Kit and RDT.
RESULTS
Seroprevalence of toxoplasmosis was 21.5% and 57.3% based on the RDT and ELISA technique, respectively. Secondary education (cOR = 1.9, 95% CI (1.1-3.1), and = 0.020) and contact with cats (cOR = 1.7, 95% CI (1.1-2.8), and = 0.030) were significant predictors of . infection, with the former being the only independent risk factor for . infection (aOR = 1.8, 95% CI (1.0-3.0), and = 0.034) by the ELISA method. The sensitivity, specificity, and area under the curve (AUC) of RDT-IgM against ELISA were 42.9%, 95.9%, and 0.694, respectively, whereas those of RDT-IgG were 31.0%, 91.2%, and 0.611, respectively. The diagnostic consistency between the two methods was fair for both RDT-IgM ( = 0.304) and RDT-IgG ( = 0.201).
CONCLUSION
The prevalence of . infection among pregnant women at Kumasi is 21.5% and 57.3% based on the RDT and ELISA technique, respectively. Secondary education and contact with cats were the major risk factors of . infection. Using ELISA as the reference, the RDT used in this study for the diagnosis of . infection has low sensitivity, and therefore, it is unreliable. However, this finding does not invalidate all RDTs because there are several other brands of RDT with good sensitivity and specificity. Further studies to ascertain the performance of other commercially available RDT kits are needed.
背景
本研究调查了加纳一家区级医院孕妇感染的流行率和危险因素，并比较了快速诊断检测（RDT）和酶联免疫吸附测定（ELISA）对 的诊断性能。
方法
这项横断面研究纳入了 400 名处于妊娠早期阶段的连续同意参与者。使用经过验证的结构化封闭式问卷收集每个参与者的社会人口统计学数据和可能的危险因素。采集血样，使用商业 ELISA 试剂盒和 RDT 分析 IgG 和 IgM。
结果
基于 RDT 和 ELISA 技术，弓形虫病的血清流行率分别为 21.5%和 57.3%。中等教育（校正比值比[cOR]=1.9，95%置信区间[CI]：1.1-3.1]，P=0.020）和接触猫（cOR=1.7，95%CI：1.1-2.8]，P=0.030）是 感染的显著预测因素，前者是 ELISA 方法检测到的 感染的唯一独立危险因素（调整比值比[aOR]=1.8，95%CI：1.0-3.0]，P=0.034）。RDT-IgM 对 ELISA 的灵敏度、特异性和曲线下面积（AUC）分别为 42.9%、95.9%和 0.694，而 RDT-IgG 的灵敏度、特异性和 AUC 分别为 31.0%、91.2%和 0.611。两种方法的诊断一致性对于 RDT-IgM（ = 0.304）和 RDT-IgG（ = 0.201）均为中等。
结论
基于 RDT 和 ELISA 技术，在库马西孕妇中， 感染的流行率分别为 21.5%和 57.3%。中等教育和接触猫是 感染的主要危险因素。使用 ELISA 作为参考，本研究中用于 感染诊断的 RDT 具有低灵敏度，因此不可靠。然而，这一发现并不能否定所有 RDT，因为还有其他几个品牌的 RDT 具有良好的灵敏度和特异性。需要进一步研究以确定其他市售 RDT 试剂盒的性能。
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