Towards the burden of human leptospirosis: duration of acute illness and occurrence of post-leptospirosis symptoms of patients in the Netherlands.
Towards the burden of human leptospirosis: duration of acute illness and occurrence of post-leptospirosis symptoms of patients in the Netherlands.
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DOI：
10.1371/journal.pone.0076549
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Hartskeerl RA
中科院分区：
文献类型：
--
作者：
Goris MG;Kikken V;Straetemans M;Alba S;Goeijenbier M;van Gorp EC;Boer KR;Wagenaar JF;Hartskeerl RA
钩端螺旋体病是一种全球性的人畜共患病。虽然对于评估钩端螺旋体病的负担很重要，但关于疾病持续时间和钩端螺旋体病后投诉发生率的数据没有得到很好的记录。因此，本研究的主要目的是估计1985年至2010年期间荷兰实验室确诊钩端螺旋体病患者的持续投诉发生率和住院时间。此外，还研究了可能影响钩端螺旋体病后投诉发生率的几个风险因素。钩端螺旋体病急性期持续时间为16天（IQR 12-23）;住院10天（IQR 7-16）。本分析排除了18例致死性病例。通过被动病例调查（CPC）对钩端螺旋体病患者的投诉来自出院后1个月的门诊咨询文件，结果显示236例实验室确诊病例中有108例（45.8%）持续投诉。对1985-1993年225例实验室确诊的钩端螺旋体病患者进行问卷调查，结果发现急性钩端螺旋体病（PCAC）后持续性主诉68例（30.2%）。经常报告的主诉包括（极度）疲劳、肌痛、不适、头痛和身体虚弱。21.1%的病例在发病后超过24个月仍有这些主诉。钩端螺旋体病后的投诉和住院治疗之间没有关联。然而，入住重症监护室（ICU）的患者在出院后根据年龄和透析进行调整后持续投诉的可能性是正常人的两倍（OR 2.0 95% CI 0.8-4.8）。虽然亚组分析表明感染Sejroe（OR 4.8，95%CI 0.9-27.0）和黄疸出血群（OR 2.0，95%CI 0.9-4.3 CI）比感染流感伤寒群更可能导致CPC，但在主诉延长和感染血清群之间未发现显著相关性。除了急性疾病，持续的投诉对钩端螺旋体病的负担有影响。
Leptospirosis is a global zoonotic disease. Although important for the assessment of the burden of leptospirosis, data on the duration of the illness and the occurrence of post-leptospirosis complaints are not well documented. Hence the main objective of this study was to estimate the occurrence of persistent complaints and duration of hospital stay in laboratory confirmed leptospirosis patients in the Netherlands during 1985 to 2010. Additionally, several risk factors potentially impacting on the occurrence of post-leptospirosis complaints were investigated. The duration of the acute phase of leptospirosis was 16 days (IQR 12–23); 10 days (IQR 7–16) were spent hospitalized. Eighteen fatal cases were excluded from this analysis. Complaints of leptospirosis patients by passive case investigations (CPC) derived from files on ambulant consultations occurring one month after hospital discharge, revealed persistent complaints in 108 of 236 (45.8%) laboratory confirmed cases. Data on persistent complaints after acute leptospirosis (PCAC), assessed in 225 laboratory confirmed leptospirosis cases collected through questionnaires during 1985-1993, indicated 68 (30.2%) PCAC cases. Frequently reported complaints included (extreme) fatigue, myalgia, malaise, headache, and a weak physical condition. These complaints prolonged in 21.1% of the cases beyond 24 months after onset of disease. There was no association between post-leptospirosis complaints and hospitalization. However, individuals admitted at the intensive care unit (ICU) were twice as likely to have continuing complaints after discharge adjusting for age and dialysis (OR 2.0 95% CI 0.8-4.8). No significant association could be found between prolongation of complaints and infecting serogroup, although subgroup analysis suggest that infection with serogroups Sejroe (OR 4.8, 95%CI 0.9-27.0) and icterohaemorrhagiae (OR 2.0, 95%CI 0.9-4.3 CI) are more likely to result in CPC than infections with serogroup Grippotyphosa. In addition to the acute disease, persistent complaints have an impact on the burden of leptospirosis.
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影响因子：
8.4
作者：
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