Epidemiological and clinical features of Plasmodium falciparum malaria in united nations personnel in Western Bahr el Ghazal State, South Sudan.
Epidemiological and clinical features of Plasmodium falciparum malaria in united nations personnel in Western Bahr el Ghazal State, South Sudan.
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DOI：
10.1371/journal.pone.0055220
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Kong L
中科院分区：
文献类型：
--
作者：
He D;Zhang Y;Liu X;Guo S;Zhao D;Zhu Y;Li H;Kong L
西加扎勒河州位于南苏丹西北部，这是一个受恶性疟原虫疟疾流行影响的热带地区。本研究旨在探讨联合国驻该地区人员恶性疟原虫的流行病学和临床特征。从2006年7月到2009年6月，对联合国二级医院678名恶性疟原虫疟疾患者的流行病学数据和医疗记录进行了分析。联合国工作人员被分为对恶性疟原虫没有免疫力的人和对恶性疟原虫有半免疫力的人。患者被分为化学预防组（遵守化学预防方案的非免疫个体，582例）和非/不完全化学预防组（非免疫个体，不完全遵守化学预防方案或根本不使用化学预防方案，半免疫个体，不使用化学预防方案，96例）。总发病率约为11.3%。半免疫和非免疫个体的发病率有显著差异（1.3% vs. 15.1%， P<0.001）。其中，82.9%的病例发生在雨季。化疗预防组的发热发生率明显低于无/不完全化疗预防组（36.8% vs. 96.9%， P<0.001）。两组之间除胃肠道症状、血清葡萄糖水平、血小板计数和丙氨酸转氨酶水平外，其他所有疟疾样症状均有显著差异。并发症发生率为1.2%（化学预防组）和44.8%（未/不完全化学预防组）。最常见的并发症是血小板减少症，在未/不完全化疗预防组中出现40.6%。综上所述，恶性疟原虫主要发生在雨季。胃肠道症状是疟疾的重要前兆。在出现胃肠道症状后，应进行血液涂片和快速诊断检查。适当的化学预防对于降低疟疾的严重程度是必要的。
Western Bahr el Ghazal State is located in northwestern South Sudan, which is a tropical area subject to Plasmodium falciparum malaria epidemics. The aim of this study is to explore the epidemiological and clinical features of Plasmodium falciparum malaria in United Nations personnel stationed in this area. From July 2006 to June 2009, epidemiological data and medical records of 678 patients with Plasmodium falciparum malaria at the U.N. level 2 hospital were analyzed. The U.N. personnel were divided into individuals not immune to Plasmodium falciparum and individuals semi-immune to Plasmodium falciparum. The patients were divided into a chemoprophylaxis group (non-immune individuals who complied with the chemoprophylaxis regimen, 582 cases) and a no/incomplete chemoprophylaxis group (non-immune individuals who either did not fully comply with chemoprophylaxis or did not use it at all and semi-immune individuals who did not use chemoprophylaxis, 96 cases). Overall morbidity was about 11.3%. There was a significant difference in the morbidity of semi-immune and non-immune individuals (1.3% vs. 15.1%, P<0.001). Out of the total, 82.9% of cases occurred during the rainy season. The incidence of fever in the chemoprophylaxis group was significantly lower than in the no/incomplete chemoprophylaxis group (36.8% vs. 96.9%, P<0.001). Significant differences were observed between the two groups with respect to all other malaria-like symptoms except gastrointestinal symptoms, serum glucose level, platelet count, and alanine aminotransferase level. The incidence of complications was 1.2% (chemoprophylaxis group) and 44.8% (no/incomplete chemoprophylaxis group).The most common complication was thrombocytopenia, which was seen in 40.6% of the no/incomplete chemoprophylaxis group. In summary, Plasmodium falciparum malaria mainly occurred in rainy season. Gastrointestinal symptoms are an important precursor of malaria. Blood smears and rapid diagnostic tests should be performed after the onset of gastrointestinal symptoms. Appropriate chemoprophylaxis is necessary for reducing the severity of malaria.
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影响因子：
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作者：
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通讯作者：
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影响因子：
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DOI：
10.4269/ajtmh.2007.76.275
发表时间：
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2002-05-01
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