Identification of Malaria Retinopathy Improves the Specificity of the Clinical Diagnosis of Cerebral Malaria: Findings from a Prospective Cohort Study
Identification of Malaria Retinopathy Improves the Specificity of the Clinical Diagnosis of Cerebral Malaria: Findings from a Prospective Cohort Study
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DOI：
10.4269/ajtmh.2010.09-0532
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发表时间：
2010-02-01
影响因子：
3.3
通讯作者：
Taylor, Terrie E.
中科院分区：
文献类型：
--
作者：
Birbeck, Gretchen L.;Beare, Nicholas;Taylor, Terrie E.
脑型疟疾（CM）的诊断在神经诊断学有限的流行地区很难确认。准确的诊断对于试验和结果研究至关重要。一项基于尸检的研究结果表明，在符合CM标准临床病例定义的儿童中识别疟疾视网膜病变可提高我们在体内准确诊断CM的能力。在一项评估CM作为癫痫风险因素的前瞻性病例对照研究的事后分析中，我们根据视网膜病变状态（存在与不存在）对符合标准病例定义的儿童进行分层，并比较这些组的既存癫痫风险因素。我们还将其与同期入组的非昏迷对照组进行比较。符合CM标准病例定义且无疟疾视网膜病变的儿童，其先前存在的发育问题和癫痫家族史的患病率较高。该患者子集可能代表既存不良神经系统症状和结局倾向的儿童。
The diagnosis of cerebral malaria (CM) is difficult to confirm in endemic regions with limited neurodiagnostics. Accurate diagnoses are critical for trials and outcomes Studies. Findings from an autopsy-based study suggest that identifying malaria retinopathy in children satisfying the standard clinical case definition of CM improves Our ability to accurately diagnose CM in vivo. In a post hoc analysis of a prospective exposure-control study to evaluate CM as a risk factor for epilepsy, we stratified children meeting the standard case definition by their retinopathy Status (presence versus absence) and compared these groups for pre-existing risk factors for epilepsy We also compared them to the concurrently enrolled, non-comatose controls. Children meeting the standard case definition of CM who lacked malaria retinopathy had a higher prevalence of pre-existing developmental problems and family history of epilepsy. This subset of patients may represent children with a pre-existing propensity to adverse neurologic symptoms and outcomes.