Prevalence and risk factors for Toxoplasma gondii infection among pregnant and postpartum women attended at public healthcare facilities in the City of Niterói, State of Rio de Janeiro, Brazil

IntroductionTo determine the prevalence of immunoglobulin G (IgG) and immunoglobulin M (IgM) anti-Toxoplasma gondii antibodies among pregnant and postpartum women attended within the public healthcare system in Niterói, State of Rio de Janeiro, and to detect possible exposure factors associated with T. gondii infection in this population.MethodsIgM and IgG anti-T. gondii antibodies were investigated in 276 pregnant and 124 postpartum women by using the indirect immunofluorescence (IFAT) and immunoenzymatic assay (ELISA) techniques. The participants were selected by convenience sampling. All these 400 patients filled out a free and informed consent statement, answered an epidemiological questionnaire and were informed about the disease.ResultsAmong the 400 samples analyzed, 234 (58.5%) were reactive to IgG anti-T. gondii antibodies, according to the IFAT and/or ELISA assay. One pregnant woman was found to be reactive to IgM anti-T. gondii antibodies, with an intermediate IgG avidity test. Risk factor analysis showed that seropositivity was significantly associated (p<0.05) with age, contact with cats and presence of rodents at home. Through a logistic regression model, these associations were confirmed for age and contact with cats, while education at least of the high school level was found to be a protective factor.ConclusionsThe prevalence rate of IgG anti-T. gondii antibodies in the City of Niterói was high and the risk factors for infection detected after multivariate analysis were: age over 30 years, contact with cats and education levels lower than university graduate level.

引言 本研究旨在确定里约热内卢州尼泰罗伊市公立医疗系统接诊的孕妇及产后妇女中，抗弓形虫免疫球蛋白G（IgG）与免疫球蛋白M（IgM）抗体的流行率，并检测该人群中与弓形虫感染相关的潜在暴露因素。方法 采用间接免疫荧光法（IFAT）与酶联免疫吸附试验（ELISA），对276名孕妇及124名产后妇女的抗弓形虫IgM、IgG抗体进行检测。本研究采用便利抽样法选取研究对象，所有400名受试者均签署了知情同意书，填写了流行病学调查问卷，并接受了该疾病相关知识宣教。结果 对400份样本的检测显示，依据间接免疫荧光法和/或酶联免疫吸附试验结果，共有234份（58.5%）样本抗弓形虫IgG抗体呈阳性反应。其中1名孕妇的抗弓形虫IgM抗体呈阳性，且IgG亲和力试验结果为中等水平。危险因素分析显示，血清阳性与年龄、接触猫类及家中存在啮齿类动物显著相关（p<0.05）。通过逻辑回归模型分析，证实了年龄与接触猫类的关联，而高中及以上学历被确定为保护因素。结论 尼泰罗伊市抗弓形虫IgG抗体的流行率较高，经多因素分析后确认的感染危险因素包括：年龄超过30岁、接触猫类，以及学历低于大学本科水平。