TICK-BORNE RELAPSING FEVER IN CENTRAL TANZANIA
TICK-BORNE RELAPSING FEVER IN CENTRAL TANZANIA
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DOI：
10.1016/0035-9203(90)90106-o
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发表时间：
1990-11-01
影响因子：
2.2
通讯作者：
COULTER, JBS
中科院分区：
文献类型：
--
作者：
BARCLAY, AJG;COULTER, JBS
1985年10月至1986年9月，在坦桑尼亚中部姆武米医院发现488名15岁以下儿童、45名孕妇、21名其他妇女和18名男子患有蜱传回归热。 88%的儿童< 5岁，36%< 1岁。 12名儿童年龄小于1个月，10名4至12天诊断的婴儿中有一些是先天性感染病例。 将儿童和孕妇中TBRF的临床特征分别与129名年龄分布相似的儿童和52名孕妇进行比较，这些儿童和孕妇的血涂片疟疾阳性，但螺旋体阴性。 TBRF患儿的常见表现为高热、脾肿大、惊厥和脑膜炎。 描述了与疟疾鉴别的困难。 儿童和成人的严重疾病与血涂片中螺旋体的高密度有关。 在45名受感染的孕妇中，22名（49%）进入分娩期。 其中一次分娩是流产，10名早产儿，其中4人死亡。 没有产妇死亡。 儿童的估计总死亡率为1.6%，1岁以下儿童为2.3%; 95名住院儿童的估计总死亡率为8.4%。 青霉素是一个令人满意的治疗所有年龄段，复发率为4.7%。 对患者管理提出了建议。
Between October 1985 and September 1986, 488 children aged less than 15 years, 45 pregnant women, 21 other women and 18 men with tick-borne relapsing fever (TBRF) were seen at Mvumi Hospital, Central Tanzania. 88% of the children were < 5 years old and 36% were < 1 year. Twelve children were < 1 month old and some of the 10 infants diagnosed at between 4 and 12 days of age were cases of congenital infection. The clinical features of TBRF in the children and pregnant women were compared with 129 children with a similar age distribution and 52 pregnant women, respectively, who had blood smears positive for malaria but negative for spirochaetes. The common presenting features in children with TBRF were a high fever, splenomegaly, convulsions, and meningism. The difficulty of differentiation from malaria is described. Severe disease in both children and adults was associated with high density of spirochaetes in blood smears. Of the 45 infected pregnant women, 22 (49%) went into labour. One of the deliveries was an abortion and 10 were preterm infants, 4 of whom died. There were no maternal deaths. The estimated overall mortality for children was 1.6%, and 2.3% for those aged < 1 years; for the 95 children admitted it was 8.4%. Penicillin was a satisfactory treatment for all ages, with a relapse rate of 4.7%. Recommendations for patient management are given.