High Prevalence of Malaria Parasitemia and Anemia among Hospitalized Children in Rakai, Uganda
High Prevalence of Malaria Parasitemia and Anemia among Hospitalized Children in Rakai, Uganda
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DOI：
10.1371/journal.pone.0082455
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发表时间：
2013-12-17
期刊：
影响因子：
3.7
通讯作者：
Wools-Kaloustian, Kara K.
中科院分区：
文献类型：
--
作者：
Kiggundu, Valerian L.;O'Meara, Wendy P.;Wools-Kaloustian, Kara K.
背景：疟疾流行区住院儿童中疟疾的数据很少。我们确定的患病率，介绍和治疗结果的疟疾和贫血的儿童在两家医院在Rakai，Uganda.Methods：五岁以下的儿童在Kalisizo医院或Bikira健康中心在Rakai区，乌干达在2011年5月至2012年5月住院，并随访，直到出院，死亡或转诊。收集的数据包括社会人口学特征、当前和既往疾病以及临床体征和症状。从手指/足跟刺血中进行血涂片、血红蛋白（Hgb）水平和HIV检测。疟疾感染和其他因素之间的关联估计使用对数二项回归估计调整后的患病风险比（aPRR）和95%的置信区间（CI），控制聚集在卫生设施。最常见的临床表现为发热（96.2%）、咳嗽（61.7%）、呕吐（44.2%）、腹泻（20.8%）和癫痫（16.0%）。疟原虫血症患病率为54.6%。患有疟疾的儿童更有可能出现发热史（aPRR 2.23; CI 1.18-4.24）和癫痫发作史（aPRR 1.12; CI 1.09-1.16）。确诊疟疾的女童人数显著低于男童（aPRR 0.92; CI 0.91-0.93）、艾滋病毒感染儿童（aPRR 0.60 CI 0.52-0.71）和腹泻儿童（aPRR 0.76; CI 0.65-0.90）。贫血（Hgb，10 g/dL）的总患病率为56.3%，重度贫血（Hgb，6 g/dL）为17.8%。在严重贫血的儿童中，76.8%患有疟原虫血症，其中93.1%接受了输血。结论：5岁以下住院儿童疟疾寄生虫血症和贫血患病率较高。预防疟疾是这一人群的优先事项。
Background: There is a paucity of data on malaria among hospitalized children in malaria endemic areas. We determined the prevalence, presentation and treatment outcomes of malaria and anemia among children in two hospitals in Rakai, Uganda.Methods: Children under five years hospitalized in Kalisizo hospital or Bikira health center in Rakai district, Uganda between May 2011 and May 2012 were enrolled and followed-up until discharge, death or referral. Data were collected on social-demographic characteristics, current and past illnesses and clinical signs and symptoms. Blood smears, hemoglobin (Hgb) levels and HIV testing were performed from finger/heel prick blood. The associations between malaria infection and other factors were estimated using log-binomial regression to estimate adjusted prevalence risk ratios (aPRR) and 95% confidence intervals (CIs), controlling for clustering at health facilities.Results: 2471 children were enrolled. The most common medical presentations were fever (96.2%), cough (61.7%), vomiting (44.2%), diarrhea (20.8%), and seizures (16.0%). The prevalence of malaria parasitemia was 54.6%. Children with malaria were more likely to present with a history of fever (aPRR 2.23; CI 1.18-4.24) and seizures (aPRR 1.12; CI 1.09-1.16). Confirmed malaria was significantly lower among girls than boys (aPRR 0.92; CI 0.91-0.93), HIV infected children (aPRR 0.60 CI 0.52-0.71), and children with diarrhea (aPRR 0.76; CI 0.65-0.90). The overall prevalence of anemia (Hgb, 10 g/dl) was 56.3% and severe anemia (Hgb, 6 g/dL) was 17.8%. Among children with severe anemia 76.8% had malaria parasitemia, of whom 93.1% received blood transfusion. Malaria associated mortality was 0.6%.Conclusion: There was a high prevalence of malaria parasitemia and anemia among inpatient children under five years. Malaria prevention is a priority in this population.