Aetiology of hospitalized fever and risk of death at Arua and Mubende tertiary care hospitals in Uganda from August 2019 to August 2020.
Aetiology of hospitalized fever and risk of death at Arua and Mubende tertiary care hospitals in Uganda from August 2019 to August 2020.
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2019年8月至2020年8月，乌干达的Arua和Mubende Tertriary Care Hospitals的病因和死亡风险。
DOI：
10.1186/s12879-022-07877-3
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发表时间：
2022-11-21
影响因子：
3.7
通讯作者：
Lamorde, Mohammed
中科院分区：
文献类型：
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作者：
Blair, Paul W.;Kobba, Kenneth;Kakooza, Francis;Robinson, Matthew L.;Candia, Emmanuel;Mayito, Jonathan;Ndawula, Edgar C.;Kandathil, Abraham J.;Matovu, Alphonsus;Aniku, Gilbert;Manabe, Yukari C.;Lamorde, Mohammed
由于艾滋病毒治疗机会的增加、新出现的病毒以及监测的加强，乌干达发热性疾病的流行病学正在发生变化。我们在乌干达的Arua和Mubende三级保健医院使用可用化验的标准化测试算法，调查了到医院就诊的成人急性发热性疾病的病因和结果。我们招募了2019年8月至2020年8月期间≥ 温度为38.0°C或在发病48小时内有发热史的成年人。记录了病史、人口统计学和生命体征。进行的检测包括完整的血细胞计数、肾和肝功能、疟疾涂片、血培养和人类免疫缺陷病毒(HIV)。当HIV阳性时，检测包括隐球菌抗原、CD4计数和尿侧向流脂阿拉伯甘露聚糖检测结核病。在住院期间和为期1个月的访问中对参与者进行跟踪。采用COX比例风险回归方法评估基线临床特征和死亡风险。在132名参与者中，年龄中位数为33.5岁(智商24至46岁)，58.3%(n = 77)为女性。总体而言，132例中有73例(55.3%)微生物学结果阳性。在艾滋病毒携带者中，45人中有31人(68.9%)至少有一次检测呈阳性；16人(35.6%)患有疟疾，14人(31.1%)患有结核病，4人(8.9%)患有隐球菌抗原血症。大多数人(65.9%)艾滋病毒阴性；87人中有42人(48.3%)至少有一项诊断试验阳性；24人(27.6%)疟疾涂片阳性，1人Xpert MTB/RIF超级阳性。总体而言，132人中有16人死亡(12.1%)；16人中有9人(56.3%)艾滋病毒阴性，6人在出院后死亡。高呼吸频率(≥ 22次/分钟)(危险比[HR]8.05；95%可信区间1.81~35.69)和低氧饱和度(HR 4.33；95%可信区间1.38~13.61)与死亡风险增加相关。在那些住院发烧的人中，疟疾和结核病是发烧疾病的常见原因，但大多数死亡是非疟疾的，大多数艾滋病毒阴性的参与者没有阳性的诊断结果。那些呼吸衰竭的人死亡的风险很高。网上版载有补充材料，可在10.1186/s12879-022-07877-3查阅。
Epidemiology of febrile illness in Uganda is shifting due to increased HIV treatment access, emerging viruses, and increased surveillance. We investigated the aetiology and outcomes of acute febrile illness in adults presenting to hospital using a standardized testing algorithm of available assays in at Arua and Mubende tertiary care hospitals in Uganda. We recruited adults with a ≥ 38.0 °C temperature or history of fever within 48 h of presentation from August 2019 to August 2020. Medical history, demographics, and vital signs were recorded. Testing performed included a complete blood count, renal and liver function, malaria smears, blood culture, and human immunodeficiency virus (HIV). When HIV positive, testing included cryptococcal antigen, CD4 count, and urine lateral flow lipoarabinomannan assay for tuberculosis. Participants were followed during hospitalization and at a 1-month visit. A Cox proportional hazard regression was performed to evaluate for baseline clinical features and risk of death. Of 132 participants, the median age was 33.5 years (IQR 24 to 46) and 58.3% (n = 77) were female. Overall, 73 (55.3%) of 132 had a positive microbiologic result. Among those living with HIV, 31 (68.9%) of 45 had at least one positive assay; 16 (35.6%) had malaria, 14 (31.1%) tuberculosis, and 4 (8.9%) cryptococcal antigenemia. The majority (65.9%) were HIV-negative; 42 (48.3%) of 87 had at least one diagnostic assay positive; 24 (27.6%) had positive malaria smears and 1 was Xpert MTB/RIF Ultra positive. Overall, 16 (12.1%) of 132 died; 9 (56.3%) of 16 were HIV-negative, 6 died after discharge. High respiratory rate (≥ 22 breaths per minute) (hazard ratio [HR] 8.05; 95% CI 1.81 to 35.69) and low (i.e., < 92%) oxygen saturation (HR 4.33; 95% CI 1.38 to 13.61) were identified to be associated with increased risk of death. In those with hospitalized fever, malaria and tuberculosis were common causes of febrile illness, but most deaths were non-malarial, and most HIV-negative participants did not have a positive diagnostic result. Those with respiratory failure had a high risk of death. The online version contains supplementary material available at 10.1186/s12879-022-07877-3.
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DOI：
10.1016/s0140-6736(18)31267-4
发表时间：
2018-07-28
期刊：
Lancet (London, England)
影响因子：
--
作者：
Gupta-Wright A;Corbett EL;van Oosterhout JJ;Wilson D;Grint D;Alufandika-Moyo M;Peters JA;Chiume L;Flach C;Lawn SD;Fielding K
通讯作者：
Fielding K
影响因子：
6.4
作者：
Mwangi, TW;Ross, A;Marsh, K
通讯作者：
Marsh, K
DOI：
10.1093/cid/ciab710
发表时间：
2022-05-30
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
通讯作者：
--
影响因子：
158.5
作者：
Danel, Christine;Moh, Raoul;Anglaret, Xavier
通讯作者：
Anglaret, Xavier
影响因子：
3.7
作者：
Kiragga, Agnes N.;Mubiru, Frank;Castelnuovo, Barbara
通讯作者：
Castelnuovo, Barbara