Demographic and clinical profiles of Plasmodium falciparum and Plasmodium vivax patients at a tertiary care centre in southwestern India
Demographic and clinical profiles of Plasmodium falciparum and Plasmodium vivax patients at a tertiary care centre in southwestern India
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DOI：
10.1186/s12936-016-1619-5
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发表时间：
2016-11-25
期刊：
影响因子：
3
通讯作者：
Rathod, Pradipsinh K.
中科院分区：
文献类型：
--
作者：
Chery, Laura;Maki, Jennifer N.;Rathod, Pradipsinh K.
背景：疟疾仍然是印度发病率和死亡率的一个重要原因。虽然在非洲和东南亚已经进行了许多综合性研究，以表征和检查恶性疟原虫和间日疟原虫疟疾发病机制的决定因素，但在印度进行的研究较少。2012年至2015年，在果阿医学院和医院（GMC）对疟疾阳性个体进行了一项前瞻性研究，以确定人口统计学，单因素分析显示恶性疟原虫和间日疟原虫感染与诊断和临床指标相关。2012年至2015年间，74，571名发热患者，6287名GMC的疟疾病例总数在四年中增加了两倍多，其中间日疟原虫和恶性疟原虫病例全年都存在。大约1116名疟疾阳性个体（平均年龄= 27岁，91%为男性），其中88.2%出生在果阿以外，51%为建筑工人，参加了这项研究。在1088例确诊的疟疾阳性患者中，77.0%为间日疟，21.0%为恶性疟，2.0%为混合疟。40岁以上的恶性疟原虫感染患者住院的可能性分别显著高于年轻患者和间日疟原虫感染患者（p < 0.001）。虽然住院的恶性疟原虫（76.6%）和间日疟原虫（78.9%）病例中出现至少一个WHO严重性指标的百分比大致相同，但恶性疟原虫住院患者中出现至少两个（43.9%，p < 0.05）和至少三个（29.9%，p < 0.01）严重性特征的百分比更高。在182例住院疟疾阳性患者中有6例死亡，所有患者均患有恶性疟原虫。结论：在GMC为期四年的研究期间，疟疾病例的数量大幅增加，严重疾病的最大负担是恶性疟原虫。
Background: Malaria remains an important cause of morbidity and mortality in India. Though many comprehensive studies have been carried out in Africa and Southeast Asia to characterize and examine determinants of Plasmodium falciparum and Plasmodium vivax malaria pathogenesis, fewer have been conducted in India.Methods: A prospective study of malaria-positive individuals was conducted at Goa Medical College and Hospital (GMC) from 2012 to 2015 to identify demographic, diagnostic and clinical indicators associated with P. falciparum and P. vivax infection on univariate analysis.Results: Between 2012 and 2015, 74,571 febrile individuals, 6287 (8.4%) of whom were malaria positive, presented to GMC. The total number of malaria cases at GMC increased more than two-fold over four years, with both P. vivax and P. falciparum cases present year-round. Some 1116 malaria-positive individuals (mean age = 27, 91% male), 88.2% of whom were born outside of Goa and 51% of whom were construction workers, were enroled in the study. Of 1088 confirmed malaria-positive patients, 77.0% had P. vivax, 21.0% had P. falciparum and 2.0% had mixed malaria. Patients over 40 years of age and with P. falciparum infection were significantly (p < 0.001) more likely to be hospitalised than younger and P. vivax patients, respectively. While approximately equal percentages of hospitalised P. falciparum (76.6%) and P. vivax (78.9%) cases presented with at least one WHO severity indicator, a greater percentage of P. falciparum inpatients presented with at least two (43.9%, p < 0.05) and at least three (29.9%, p < 0.01) severity features. There were six deaths among the 182 hospitalised malaria positive patients, all of whom had P. falciparum.Conclusion: During the four year study period at GMC, the number of malaria cases increased substantially and the greatest burden of severe disease was contributed by P. falciparum.