上海市输入性疟疾临床流行病学特征分析

发布时间：2018-05-20 19:45

本文选题：输入性疟疾 + 流行病学特征　；参考：《中国寄生虫学与寄生虫病杂志》2017年02期

【摘要】：目的评估上海地区输入性疟疾流行病学特征及重症疟疾的危险因素。方法回顾性收集2013-2015年收治于上海市公共卫生临床中心的输入性疟疾病例资料,分析人口学、流行病学、实验室检查数据。组间比较采用Mann-Whitney法和Fisher’s精确检验,logistic回归分析危险因素评估。结果共收集输入性疟疾病例87例,平均发病年龄为36.4岁,男性82例(94.3%),女性5例(5.7%)。其中中国患者79例(90.8%),南苏丹3例(3.4%),印度2例(2.3%),喀麦隆、尼日利亚、布隆迪各1例(1.1%)。在75例能够明确感染来源地国家的病例中,感染来源地为非洲国家的多达63例(84.0%),其次为亚洲(11例,14.7%)。实验室确诊病例78例(89.7%),临床诊断病例9例(10.3%)。在实验室确诊病例中,感染恶性疟原虫(Plasmodium falciparum)最多,为66例(84.6%),感染间日疟原虫(P.vivax)10例(12.8%)。20例(23.0%)患者既往有疟疾史。患者发病至住院的中位数时间为5 d,30例(34.5%)患者在发病后的48 h内服用抗疟疾药物。符合重症疟疾标准的18例,其中1例为脑型疟,17例总胆红素43μmol/L,3例血清肌酐265μmol/L。多因素logistic回归分析显示,发病后48 h内服用抗疟药是预测重症疟疾的独立的危险因子(OR=0.05,95%置信区间0.01~0.43,P0.05)。结论恶性疟原虫是本市输入性疟疾病例感染的主要虫种,非洲是主要的感染来源地。发病后及时给予抗疟治疗可降低重症疟疾的发生风险。
[Abstract]:Objective to evaluate the epidemiological characteristics of imported malaria and risk factors of severe malaria in Shanghai. Methods data of imported malaria cases admitted to Shanghai Public Health Clinical Center from 2013 to 2015 were collected retrospectively, and demographic, epidemiological and laboratory data were analyzed. The risk factors were evaluated by Mann-Whitney and Fisher's analysis. Results A total of 87 cases of imported malaria were collected. The average age of onset was 36.4 years old, 82 cases were male, and 5 cases were female. There were 79 cases in China, 3 cases in South Sudan, 2 cases in India, 1 case in Cameroon, 1 case in Nigeria and 1 case in Burundi. Of the 75 cases that could identify the country of origin, 63 cases were from African countries, followed by 11 cases from Asia. 78 cases were diagnosed by laboratory and 9 cases by clinical diagnosis. Among the laboratory confirmed cases, Plasmodium falciparum (66 cases) and P. vivaxae (10 cases) had a history of malaria. The median time from onset to hospitalization was 5 days and 30 patients took antimalarial drugs within 48 hours after onset. Among the 18 patients who met the criteria of severe malaria, one case was cerebral malaria, 17 cases were total bilirubin 43 渭 mol / L, 3 cases were serum creatinine 265 渭 mol 路L ~ (-1). Multivariate logistic regression analysis showed that taking antimalarial drugs within 48 hours after onset was an independent risk factor for predicting severe malaria. Conclusion Plasmodium falciparum is the main infectious species of imported malaria cases in this city, and Africa is the main source of infection. The risk of severe malaria can be reduced by timely antimalarial treatment after onset.
【作者单位】：复旦大学附属上海市公共卫生临床中心;复旦大学附属华山医院;
【分类号】：R181.3;R531.3

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