HIV infection, malnutrition, and invasive bacterial infection among children with severe malaria.
HIV infection, malnutrition, and invasive bacterial infection among children with severe malaria.
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DOI：
10.1086/600299
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发表时间：
2009-08-01
期刊：
影响因子：
--
通讯作者：
Newton CR
中科院分区：
文献类型：
--
作者：
Berkley JA;Bejon P;Mwangi T;Gwer S;Maitland K;Williams TN;Mohammed S;Osier F;Kinyanjui S;Fegan G;Lowe BS;English M;Peshu N;Marsh K;Newton CR
据报告，患有严重疟疾的儿童中有艾滋病毒感染、营养不良和侵入性细菌感染。然而，尚不清楚它们与恶性疟原虫寄生和严重疾病同时发生是偶然的，还是与疟疾流行地区儿童之间的关联。我们检查了3,068名连续入院的肯尼亚地区医院的严重疟疾临床特征的儿科患者和592名社区对照。我们进行了多变量回归分析，每个病例加权的概率是由于恶性疟疾使用的估计严重疾病的比例归因于疟疾在不同的寄生虫密度来自横截面寄生虫学调查，以及在同一社区的儿童。133/1071（12%，95%CI 11 - 15%）例连续寄生虫血症患者存在HIV感染。感染艾滋病毒的儿童体内寄生虫密度较高。与HIV感染相关的入院率为9.6（95%CI 4.9 - 19），但仅限于1岁以上的儿童。在507/2,048例（25%，95%CI 23 - 27%）连续寄生虫血症患者中存在营养不良。营养不良与重症恶性疟疾入院的相关性为4.0（95%CI 2.9 - 5.5）。在127/2，048（6.2%，95%CI 5.2 - 7.3%）例连续寄生虫血症住院患者中检测到IBI。所有三种合并症都与病死率增加有关。艾滋病毒、营养不良和IBI在生物学上与恶性疟疾引起的严重疾病有关，而不仅仅是流行地区同时寄生虫感染儿童的替代诊断。
HIV infection, malnutrition and invasive bacterial infections (IBI) are reported among children with severe malaria. However, it is unclear whether their co-occurrence with falciparum parasitization and severe disease is by chance, or by association among children in malaria endemic areas. We examined 3,068 consecutive paediatric admissions to a Kenyan district hospital with clinical features of severe malaria, and 592 community controls. We performed multivariable regression analysis with each case weighted for their probability of being due to falciparum malaria using estimates of the fraction of severe disease attributable to malaria at different parasite densities derived from cross sectional parasitological surveys from well children in the same community. HIV infection was present in 133/1071 (12%, 95%CI 11 to 15%) consecutive parasitemic admissions. Parasite densities were higher in HIV infected children. The odds of admission associated with HIV infection for admission with true severe falciparum malaria were 9.6 (95%CI 4.9 to 19), however this effect was restricted to children age ≥1 year. Malnutrition was present in 507/2,048 (25%, 95%CI 23 to 27%) consecutive parasitemic admissions. The odds associated with malnutrition for admission with true severe falciparum malaria were 4.0 (95%CI 2.9 to 5.5). IBI was detected in 127/2,048 (6.2%, 95%CI 5.2 to 7.3%) of consecutive parasitemic admissions. All three comorbidities were associated with increased case fatality. HIV, malnutrition and IBI are biologically associated with severe disease due to falciparum malaria rather than being simply alternative diagnoses in co-incidentally parasitized children in an endemic area.
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影响因子：
6.4
作者：
Mwangi, TW;Ross, A;Marsh, K
通讯作者：
Marsh, K
影响因子：
3.6
作者：
Grimwade, K;French, N;Gilks, CF
通讯作者：
Gilks, CF
影响因子：
15.8
作者：
Bejon P;Berkley JA;Mwangi T;Ogada E;Mwangi I;Maitland K;Williams T;Scott JA;English M;Lowe BS;Peshu N;Newton CR;Marsh K
通讯作者：
Marsh K
影响因子：
11.8
作者：
Korenromp, EL;Williams, BG;Nahlen, BL
通讯作者：
Nahlen, BL
DOI：
10.1016/s0035-9203(99)90024-x
发表时间：
1999-05-01
影响因子：
2.2
作者：
Berkley, J;Mwarumba, S;Marsh, K
通讯作者：
Marsh, K