本文選題：輸入性瘧疾 + 流行病學特征�。� 參考：《中國寄生蟲學與寄生蟲病雜志》2017年02期

【摘要】：目的評估上海地區(qū)輸入性瘧疾流行病學特征及重癥瘧疾的危險因素。方法回顧性收集2013-2015年收治于上海市公共衛(wèi)生臨床中心的輸入性瘧疾病例資料,分析人口學、流行病學、實驗室檢查數(shù)據(jù)。組間比較采用Mann-Whitney法和Fisher’s精確檢驗,logistic回歸分析危險因素評估。結(jié)果共收集輸入性瘧疾病例87例,平均發(fā)病年齡為36.4歲,男性82例(94.3%),女性5例(5.7%)。其中中國患者79例(90.8%),南蘇丹3例(3.4%),印度2例(2.3%),喀麥隆、尼日利亞、布隆迪各1例(1.1%)。在75例能夠明確感染來源地國家的病例中,感染來源地為非洲國家的多達63例(84.0%),其次為亞洲(11例,14.7%)。實驗室確診病例78例(89.7%),臨床診斷病例9例(10.3%)。在實驗室確診病例中,感染惡性瘧原蟲(Plasmodium falciparum)最多,為66例(84.6%),感染間日瘧原蟲(P.vivax)10例(12.8%)。20例(23.0%)患者既往有瘧疾史。患者發(fā)病至住院的中位數(shù)時間為5 d,30例(34.5%)患者在發(fā)病后的48 h內(nèi)服用抗瘧疾藥物。符合重癥瘧疾標準的18例,其中1例為腦型瘧,17例總膽紅素43μmol/L,3例血清肌酐265μmol/L。多因素logistic回歸分析顯示,發(fā)病后48 h內(nèi)服用抗瘧藥是預測重癥瘧疾的獨立的危險因子(OR=0.05,95%置信區(qū)間0.01~0.43,P0.05)。結(jié)論惡性瘧原蟲是本市輸入性瘧疾病例感染的主要蟲種,非洲是主要的感染來源地。發(fā)病后及時給予抗瘧治療可降低重癥瘧疾的發(fā)生風險。
[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.
【作者單位】： 復旦大學附屬上海市公共衛(wèi)生臨床中心;復旦大學附屬華山醫(yī)院;
【分類號】：R181.3;R531.3

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