Knowledge and Preventive Behaviour among Pregnant Women with Latent Toxoplasmosis in Malaysia

Latent Toxoplasmosis in Malaysian Pregnant Women
Vol. 15 No. 2 : 2020 (108-123)

Ahmad N Ahmad N
Osman E Osman E
Abdul Ghani NA Abdul Ghani NA
Leong WY Leong WY
Arzaee MZ Arzaee MZ
Seow YY Seow YY
Dol Bahar S Dol Bahar S
Wan Yahya WNN Wan Yahya WNN
Mustapha N Mustapha N
Vadiveel Y Vadiveel Y

Abstract
Latent toxoplasmosis could induce various hormonal and behavioural perturbations in infected hosts. We aimed to study the latent seroprevalence of Toxoplasma gondii (T. gondii) and the relationship between infection, knowledge and behaviour among 400 pregnant mothers. Plasma samples were tested for the presence of T. gondii IgG antibodies while a structured questionnaire was used to record respondents’ socio-demographic characteristics, general information and knowledge on plausible risk factors, symptoms, timing of infection, and preventive knowledge and behaviour regarding toxoplasmosis. The seroprevalence of latent toxoplasmosis among respondents was at 31.8%. This study indicated that 69.5% of them had poor knowledge of toxoplasmosis but most of them (99.8%) practised preventive behaviours. Multiple logistic regression analysis showed that pregnant women with low education levels (aOR: 1.91, 95% CI 1.18, 3.10; p = 0.008) and past medical history (aOR: 2.32, 95% CI 1.32, 4.06; p = 0.003) were both twice as likely to have anti-T. gondii IgG seropositivity. Besides, women who were unsure regarding the transmission mode of the disease via blood transfusion were four times more likely (aOR: 3.93, 95% CI 1.54, 10.01; p = 0.004) to have chronic toxoplasmosis seroprevalence. Women who were unsure regarding the necessities of avoiding stray cats had aOR of 0.42 (95% CI 0.24, 0.71, p = 0.001) for chronic toxoplasmosis seroprevalence. Translating the knowledge on toxoplasmosis into the practice of preventive behaviour via a health education programme is crucial in reducing the risk of disease transmission especially among pregnant women.
Keywords : Attitude, knowledge, practice, pregnant mother, seroprevalence, Toxoplasma gondii, toxoplasmosis,
Abstrak
Toksoplasmosis pendam dapat menyebabkan pelbagai gangguan hormon dan tingkah laku dalam hos terjangkit. Kami berhasrat untuk mengkaji sero-prevalens Toxoplasma gondii (T. gondii) pendam serta hubungan antara jangkitan dengan pengetahuan dan tingkah laku dalam kalangan 400 ibu hamil. Sampel plasma diuji untuk kehadiran antibodi IgG T. gondii dan soal selidik berstruktur digunakan untuk merekodkan ciri-ciri sosio-demografi responden, maklumat umum dan pengetahuan mengenai faktor risiko, gejala, masa jangkitan, pengetahuan pencegahan serta tingkah laku pencegahan toksoplasmosis. Sero-prevalensi toksoplasmosis pendam dalam wanita hamil adalah 31.8%. Kajian menunjukkan, 69.5% daripada mereka mempunyai kurang pengetahuan mengenai toksoplasmosis. Walau bagaimanapun, majoritinya (99.8%) mengamalkan tingkah laku pencegahan. Analisis regresi logistik berganda menunjukkan wanita hamil dengan tahap pendidikan rendah mempunyai  hampir dua kali lebih risiko (nisbah ods terlaras: 1.91, 95% SK 1.18, 3.10; p = 0.008) untuk T. gondii IgG seropositif. Wanita hamil yang mempunyai sejarah perubatan  lalu mempunyai dua kali lebih kemungkinan (nisbah ods terlaras: 2.32, 95% SK 1.32, 4.06; p = 0.003) untuk T. gondii IgG seropositif. Selain itu, wanita yang tidak pasti mengenai mod penyebaran penyakit melalui pemindahan darah mempunyai empat kali lebih ods (nisbah ods terlaras: 3.93, 95% SK 1.54, 10.01; p = 0.004) untuk sero-prevalens kronik toksoplasmosis. Wanita yang tidak pasti mengenai keperluan menghindari kucing liar mempunyai nisbah ods terlaras: 0.42 (95% SK 0.24, 0.71, p = 0.001) untuk sero-prevalens kronik toksoplasmosis. Penterjemahan pengetahuan tentang toksoplasmosis kepada amalan tingkah laku pencegahan melalui program pendidikan kesihatan adalah penting untuk mengurangkan risiko penularan penyakit ini dalam kalangan wanita hamil.
Kata Kunci : Amalan, ibu hamil, pengetahuan, sero-prevalens, sikap, Toksoplasma gondii, toksoplasmosis,

Correspondance Address
Emelia Osman. Department of Parasitology & Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +603-91459595 Email: emelia.osman@ppukm.ukm.edu.my