Evaluation of reported malaria chemoprophylactic failure among travelers in a US university exchange program, 2002
Evaluation of reported malaria chemoprophylactic failure among travelers in a US university exchange program, 2002
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DOI：
10.1086/425311
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发表时间：
2004-12-01
影响因子：
11.8
通讯作者：
Newman, RD
中科院分区：
文献类型：
--
作者：
Causer, LM;Filler, S;Newman, RD
背景前往疟疾流行地区的旅行者有感染疟疾的危险;然而，通过化学预防和及时有效的治疗，感染的严重并发症一般是可以预防的。在2002年6月，我们调查了一组疟疾病例的报告，美国大学的工作人员和学生谁访问了加纳，据报道，坚持适当的疟疾化疗。我们对所有参与者进行问卷调查，并从加纳血涂片诊断为疟疾感染的报告者中收集血液标本进行疟疾血清学检查。在33名参与者中，有25人完成了调查问卷。24人服用了疾病控制和预防中心推荐的化学预防药物; 25人中有14人（56%）报告完全依从治疗。25例受试者中有20例（80%）报告了与可能的疟疾一致的症状。其中6人报告经显微镜诊断患有疟疾，并在加纳接受了治疗。使用从其中5名参与者获得的血液样本进行疟疾血清学检查;所有结果均为阴性，表明疟疾的诊断不正确。一个人在国外时对疟疾的误诊不仅可能导致抗药性的错误报告，而且还可能导致不必要的抗疟治疗。卫生保健提供者和公共卫生当局必须严格评估化学预防失败的报告，并向旅行者传播准确的信息。
Background. Travelers to malarious areas are at risk of acquiring malaria; however, with chemoprophylaxis and prompt, effective therapy, serious complications of infection are generally preventable. In June 2002, we investigated a report of a cluster of malaria cases among US university staff and students who visited Ghana and were reportedly adherent to appropriate malaria chemoprophylaxis.Methods. We administered a questionnaire to all participants and collected blood specimens for malaria serological examinations from those reporting malaria infection diagnosed by blood smear in Ghana.Results. Of the 33 participants, 25 completed the questionnaire. Twenty-four took a Centers for Disease Control and Prevention - recommended chemoprophylactic drug; 14 ( 56%) of 25 reported complete adherence to therapy. Twenty (80%) of 25 subjects reported symptoms consistent with possible malaria. Six of these persons reported a microscopic diagnosis of malaria and were treated in Ghana. Serological examination for malaria was performed using blood samples obtained from 5 of these participants; the results for all were negative, suggesting that incorrect diagnoses of malaria were made.Conclusions. Misdiagnosis of malaria made while a person is abroad may not only lead to erroneous reports of drug resistance, but it could also result in unnecessary administration of antimalarial treatment. Health care providers and public health authorities must critically evaluate reports of chemoprophylactic failures and disseminate accurate information to travelers.