Antibiotic use among patients with febrile illness in a low malaria endemicity setting in Uganda.
Antibiotic use among patients with febrile illness in a low malaria endemicity setting in Uganda.
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DOI：
10.1186/1475-2875-10-377
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发表时间：
2011-12-20
期刊：
影响因子：
3
通讯作者：
Nuwaha F
中科院分区：
文献类型：
--
作者：
Batwala V;Magnussen P;Nuwaha F
乌干达接受了世界卫生组织的指南，该指南建议对疟疾采取普遍的“检测和治疗”策略，主要是使用快速诊断测试（RDT）和显微镜检查。然而，人们很少知道疟疾寄生虫学诊断的增加如何影响发热性疾病患者的抗生素治疗。数据收集是在疟疾推定诊断（对照）和低传播强度地区的两种诊断干预措施（显微镜或 RDT）的可行性试验中进行的。五个初级卫生中心 (HC) 被随机分配到每个诊断组（指定患者组的诊断方法）。所有 52,116 名年龄在 5 个月至 95 岁之间出现发热（根据陈述或测量）的门诊患者（推定 16,971 例；镜检 17,508 例；RDT 17,638 例）均纳入其中。从 2010 年 3 月到 2011 年 7 月，每周都会从门诊患者和实验室登记处提取信息。根据未接受疟疾检测、检测呈阳性和检测呈阴性的患者计算出服用抗生素的患者比例。假定组中的 7040 名患者 (41.5%) 接受了抗生素治疗。在未接受疟疾检测的患者中，显微镜检查组的 1,537 名患者（23.9%）和 RDT 组的 810 名患者（56.2%）服用了抗生素。在疟疾检测呈阳性的患者中，845 名（25.8%）在 RDT 中接受了抗生素治疗，273 名（17.6%）在显微镜检查组中接受了抗生素治疗。在疟疾检测呈阴性的患者中，7809 名（61.4%）在 RDT 中接受了抗生素治疗，3749 名（39.3%）在显微镜检查组中接受了抗生素治疗。总体而言，与五岁及以上儿童 16798 (38.6%) 相比，五岁以下儿童 5,388 (63%) 开抗生素处方更为常见。发热性疾病患者的抗生素处方率很高。疟疾检测呈阳性会减少抗生素治疗，但疟疾检测呈阴性会增加抗生素的使用。 ClinicalTrials.gov：NCT00565071
Uganda embraced the World Health Organization guidelines that recommend a universal 'test and treat' strategy for malaria, mainly by use of rapid diagnostic test (RDT) and microscopy. However, little is known how increased parasitological diagnosis for malaria influences antibiotic treatment among patients with febrile illness. Data collection was carried out within a feasibility trial of presumptive diagnosis of malaria (control) and two diagnostic interventions (microscopy or RDT) in a district of low transmission intensity. Five primary level health centres (HCs) were randomized to each diagnostic arm (diagnostic method in a defined group of patients). All 52,116 outpatients (presumptive 16,971; microscopy 17,508; and RDT 17,638) aged 5 months to ninety five years presenting with fever (by statement or measured) were included. Information from outpatients and laboratory registers was extracted weekly from March 2010 to July 2011. The proportion of patients who were prescribed antibiotics was calculated among those not tested for malaria, those who tested positive and in those who tested negative. Seven thousand and forty (41.5%) patients in the presumptive arm were prescribed antibiotics. Of the patients not tested for malaria, 1,537 (23.9%) in microscopy arm and 810 (56.2%) in RDT arm were prescribed antibiotics. Among patients who tested positive for malaria, 845 (25.8%) were prescribed antibiotics in the RDT and 273(17.6%) in the microscopy arm. Among patients who tested negative for malaria, 7809 (61.4%) were prescribed antibiotics in the RDT and 3749 (39.3%) in the microscopy arm. Overall the prescription of antibiotics was more common for children less than five years of age 5,388 (63%) compared to those five years and above 16798 (38.6%). Prescription of antibiotics in patients with febrile illness is high. Testing positive for malaria reduces antibiotic treatment but testing negative for malaria increases use of antibiotics. ClinicalTrials.gov: NCT00565071
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影响因子：
3
作者：
Dodoo, Alexander N. O.;Fogg, Carole;Ofori-Adjei, David
通讯作者：
Ofori-Adjei, David
影响因子：
--
作者：
STOTT, NCH;WEST, RR
通讯作者：
WEST, RR
快速疟疾诊断测试对发烧患者治疗和健康结果的影响，桑给巴尔：一项跨界验证研究。
影响因子：
15.8
作者：
Msellem MI;Mårtensson A;Rotllant G;Bhattarai A;Strömberg J;Kahigwa E;Garcia M;Petzold M;Olumese P;Ali A;Björkman A
通讯作者：
Björkman A
DOI：
10.4269/ajtmh.2006.75.219
发表时间：
2006-08-01
影响因子：
3.3
作者：
Okello, Paul Edward;Van Bortel, Wim;Coosemans, Marc
通讯作者：
Coosemans, Marc
影响因子：
120.7
作者：
Gonzales, R;Steiner, JF;Sande, MA
通讯作者：
Sande, MA