Rift Valley fever epidemic in Saudi Arabia: Epidemiological, clinical, and laboratory characteristics
Rift Valley fever epidemic in Saudi Arabia: Epidemiological, clinical, and laboratory characteristics
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DOI：
10.1086/378747
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发表时间：
2003-10-15
影响因子：
11.8
通讯作者：
Shobokshi, O
中科院分区：
文献类型：
--
作者：
Madani, TA;Al-Mazrou, YY;Shobokshi, O
这项队列描述性研究总结了2000年8月26日至2001年9月22日在沙特阿拉伯发生的裂谷热(RVF)疫情的流行病学、临床和实验室特征。共报告886例。在834例有实验室结果的报告病例中，81.9%的病例经实验室确认，其中51.1%的病例仅RVF免疫球蛋白M阳性，35.7%的病例仅RVF抗原阳性，13.2%的病例两者均阳性。临床和实验室特征包括发热(92.6%)、恶心(59.4%)、呕吐(52.6%)、腹痛(38.0%)、腹泻(22.1%)、黄疸(18.1%)、神经系统症状(17.1%)、出血症状(7.1%)、视力丧失或暗点(1.5%)、肝酶升高(98%)。乳酸脱氢酶升高(60.2%)，血小板减少(38.4%)，白细胞减少(39.7%)，肾功能损害或衰竭(27.8%)，肌酸激酶水平升高(27.3%)，严重贫血(15.1%)。病死率13.9%。出血、神经系统症状和黄疸与高死亡率独立相关。白细胞减少的患者的死亡率显著低于白细胞计数正常或高的患者(2.3%比27.9%；优势比0.09；95%可信区间0.01-0.63)。
This cohort descriptive study summarizes the epidemiological, clinical, and laboratory characteristics of the Rift Valley fever (RVF) epidemic that occurred in Saudi Arabia from 26 August 2000 through 22 September 2001. A total of 886 cases were reported. Of 834 reported cases for which laboratory results were available, 81.9% were laboratory confirmed, of which 51.1% were positive for only RVF immunoglobulin M, 35.7% were positive for only RVF antigen, and 13.2% were positive for both. The mean age (+/- standard deviation) was years, and the ratio of male to female patients was 4:1. Clinical and laboratory features included 46.9 +/- 19.4 fever (92.6% of patients), nausea (59.4%), vomiting (52.6%), abdominal pain (38.0%), diarrhea (22.1%), jaundice (18.1%), neurological manifestations (17.1%), hemorrhagic manifestations (7.1%), vision loss or scotomas (1.5%), elevated liver enzyme levels (98%), elevated lactate dehydrogenase level (60.2%), thrombocytopenia (38.4%), leukopenia (39.7%), renal impairment or failure (27.8%), elevated creatine kinase level (27.3%), and severe anemia (15.1%). The mortality rate was 13.9%. Bleeding, neurological manifestations, and jaundice were independently associated with a high mortality rate. Patients with leukopenia had significantly a lower mortality rate than did those with a normal or high leukocyte count (2.3% vs. 27.9%; odds ratio, 0.09; 95% confidence interval, 0.01-0.63).