A cross-sectional study on clinical vigilance in the diagnosis and treatment of listeriosis among pregnant women and their knowledge, attitudes, and practices regarding listeriosis in Gansu Province, China

TL;DR

This study examines how well doctors in China's Gansu Province diagnose listeriosis and how pregnant women there understand and manage the disease.

Contribution

The paper provides the first population-based assessment of listeriosis clinical vigilance and knowledge among pregnant women in Gansu Province.

Findings

Only 14.98% of physicians had treated listeriosis or received relevant training.

Pregnant women with lower education showed higher risky food handling behaviors.

First-time mothers were more likely to engage in high-risk dietary behaviors.

Abstract

Listeriosis is a serious foodborne disease that threatens the health of pregnant women and their fetuses. Gansu Province, in northwest China, is economically underdeveloped and covers a large geographic area. No population-based studies on listeriosis have been conducted there. In 2022, Gansu added listeriosis to its foodborne disease surveillance system and started a pilot program at five tertiary hospitals in four cities. By the end of 2024, 13 confirmed cases had been reported, including three linked to pregnancy: one miscarriage and two preterm births at 27 weeks and 34 weeks plus 2 days, respectively.

This study aims to assess the clinical vigilance for listeriosis in Gansu Province and to investigate pregnant women’s knowledge, attitudes, and practices (KAP) regarding the disease.

Eight tertiary hospitals were selected as research sites. A convenience sampling method was used to survey 207 physicians from obstetrics, emergency medicine, and gastroenterology departments, along with 589 pregnant women receiving prenatal care. Descriptive statistics were generated using WPS Office 10.8.0, while SPSS 21.0 was employed for ANOVA, Spearman correlation analysis, and multiple linear regression modeling.

The proportion of physicians who had treated listeriosis patients and those who had participated in relevant training was identical at 14.98%. Failure to diagnose the disease was identified as the primary reason for underreporting among clinicians. A low percentage of physicians were aware of foods commonly contaminated by Listeria monocytogenes, as well as the main clinical symptoms and recommended treatment options for listeriosis. Over half of the surveyed pregnant women reported cleaning their refrigerators no more than twice per year, consumed high-risk foods within 4 weeks prior to the survey, and failed to separate raw and cooked foods on cutting boards at home. Pregnant women with lower-educated pregnant women showed higher rates of using the same cutting board for raw and cooked foods and poor handwashing habits. All differences were statistically significant (χ2 = 13.177, 9.939; all p < 0.05), Those first-time pregnant women were more likely to eat at mobile food stalls, consume high-risk foods, and clean refrigerators≤2 times/year than non-first-time mothers (χ2 = 4.267, 10.436, 14.150; all p < 0.05). Higher overall scores on listeriosis-related knowledge, attitudes, and behaviors were associated with advanced maternal age, higher education level, increased family income, later gestational stage, and being a first-time mother.

Clinical vigilance for listeriosis diagnosis and treatment among physicians in tertiary hospitals remains limited. Pregnant women exhibit low awareness of listeriosis and engage in high-risk behaviors at elevated rates.

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