[Seroprevalence and risk factors of Toxoplasma gondii infections among high-risk populations in Changzhou City].

Objective To understand the prevalence and risk factors of Toxoplasma gondii infections among high-risk populations in Changzhou City, so as to provide the scientific basis for formulating effective control measures of toxoplasmosis. Methods Four types of high-risk populations living in Changzhou City were recruited from 2016 to 2018 as the study subjects, including HIV/AIDS patients, cancer patients, pregnant women and livestock and poultry breeding or processing workers. Each subject was investigated for the knowledge on knowledge, attitude and practice of toxoplasmosis prevention and control. In addition, serum specific IgG and IgM antibodies against T. gondii were detected, and the risk factors of T. gondii infections were identified. Results A total of 900 participants at high risk of T. gondii infections were investigated in Changzhou City from 2016 to 2018, including 150 HIV/AIDS patients, 250 cancer patients, 250 pregnant women and 250 livestock and poultry breeding or processing workers. The overall awareness rate of toxoplasmosis prevention and control knowledge was 16.8% (151/900), and the awareness rate was significantly greater in women than in men ( χ 2 = 41.34, P < 0.05). The awareness rate of toxoplasmosis prevention and control reduced with ages ( χ 2 = 147.78, P < 0.05), and increased with the education level ( χ 2 = 166.42, P < 0.05). In ad dition, there was an occupation-specific awareness rate of toxoplasmosis prevention and control ( χ 2 = 92.26, P < 0.05), and the highest awareness rate was seen in cadres and staff (47.2%, 34/72). Among all high-risk populations, 34.6% (311/900) had fre- quent contacts with cats/dogs, 40.4% (364/900) raised cats/dogs at home, 0.9% (8/900) ate raw meat, and 15.8% (142/900) sepa- rated chopping boards for raw and cooked food. Among the participants aware of toxoplasmosis prevention and control knowledge, 24.5% (37/151) contacted cats/dogs frequently, which was significantly lower than those not aware of toxoplasmosis prevention and control knowledge (36.6%, 274/749) ( χ 2 = 8.11, P < 0.05), and 35.1% (53/151) separated chopping boards for raw and cooked food, which was significantly higher than those not aware of toxoplasmosis prevention and control knowledge (11.9%, 89/749) ( χ 2 = 50.97, P < 0.05). The overall seroprevalence of T. gondii infections was 11.0% (99/900), and the positive rates of IgG antibodies against T. gondii were 6.0%, 13.9%, 4.8% and 17.3% in HIV/AIDS patients, livestock and poultry breeding or processing workers, pregnant women and cancer patients, respectively ( χ 2 = 25.87, P < 0.05). A higher seroprevalence of T. gon- dii infection was seen in men than in women ( χ 2 = 8.88, P < 0.05), and the seroprevalence increased with ages ( χ 2 = 37.03, P < 0.05) and reduced with education levels ( χ 2 = 25.07, P < 0.05). There was an occupation-specific seroprevalence of T. gondii in- fection ( χ 2 = 22.09, P < 0.05), and the highest seroprevalence was detected in peasants (57/330, 17.3%). Conclusion The awareness of toxoplasmosis prevention and control knowledge is low among high-risk populations in Changzhou City. Health edu- cation pertaining to toxoplasmosis prevention and control requires to be strengthened in cancer patients and livestock and poultry breeding or processing workers who have a high seroprevalence of T. gondii infections, so as to change the poor behavior styles. ［摘要］ 目的 了解常州市高危人群弓形虫感染情况及其影响因素, 为后续制定有效弓形虫病防治措施提供科学依据。 方法 2016—2018年, 选择常州市HIV/AIDS患者、肿瘤病人、孕妇及畜禽产品养殖加工人员等4类高危人群为调查对 象, 进行个案调查及弓形虫病防治知信行问卷调查, 并对血清抗弓形虫特异性IgG、IgM抗体进行检测, 比较抗体阳性率 差异, 对弓形虫感染相关危险因素进行分析。 结果 2016—2018年累计调查900人, 其中HIV/AIDS患者150人, 肿瘤病 人、孕妇及畜禽产品养殖加工人员各250人。调查对象弓形虫病防治知识总体知晓率为16.8% (151/900), 女性知晓率显 著高于男性 ( χ 2 = 41.34, P < 0.05), 知晓率随年龄增长而下降 ( χ 2 = 147.78, P < 0.05) ; 不同职业人群知晓率差异有统计学 意义 ( χ 2 = 92.26, P < 0.05), 以干部职员知晓率最高 (47.2%, 34/72) ; 知晓率随文化程度增高而上升 ( χ 2 = 166.42, P < 0.05) 。所有调查人群中, 经常与猫/犬接触者占34.6% (311/900), 家里养猫/犬者占40.4% (364/900), 生食肉类者占0.9% (8/900), 生熟砧板分开者占15.8% (142/900) 。知晓弓形虫病防治知识人群中, 经常接触猫/犬者占24.5% (37/151), 显著 低于不知晓者 (36.6%, 274/749; χ 2 = 8.11, P < 0.05) ; 生熟砧板分开者占35.1% (53/151), 显著高于不知晓者 (11.9%, 89/749; χ 2 = 50.97, P < 0.05) 。调查对象血清抗弓形虫抗体总体检出率为11.0% (99/900), HIV/AIDS患者、畜禽产品养殖 加工人员、孕妇及肿瘤病人血清抗弓形虫IgG抗体阳性率分别为6.0%、13.9%、4.8%和17.3%, 差异有统计学意义 ( χ 2 = 25.87, P < 0.05) 。男性抗弓形虫抗体检出率显著高于女性 ( χ 2 = 8.88, P < 0.05) ; 抗体检出率随年龄增长而上升 ( χ 2 = 37.03, P < 0.05) ; 不同职业人群抗体检出率差异有统计学意义 ( χ 2 = 22.09, P < 0.05), 以农民检出率最高 (17.3%, 57/330) ; 抗体检出率随文化程度增高而下降 ( χ 2 = 25.07, P < 0.05) 。 结论 常州市高危人群弓形虫病防治知识知晓率较低, 肿瘤 病人和畜禽产品养殖加工人员血清抗弓形虫IgG抗体检出率较高。应加强常州市高危人群弓形虫病健康教育, 改变不 良生活行为方式。