Akramuzzaman S M, Cutts F T, Wheeler J G, Hossain M J
Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.
Am J Epidemiol. 2000 Apr 1;151(7):723-35. doi: 10.1093/oxfordjournals.aje.a010267.
In a 1995-1996 cohort study in the city of Dhaka, Bangladesh, morbidity in 117 hospitalized and 137 acute measles cases compared with age-matched children without measles (unexposed) was determined by weekly interview for 6 months. Compared with unexposed children, there were higher incidences of hospitalization (adjusted rate ratio (RR) = 3.1, 95% confidence interval (CI): 1.3, 7.6) and bloody diarrhea (adjusted RR = 2.7, 95% CI: 1.4, 5.1) in hospital measles cases during the 6 weeks after recruitment. Among community cohorts, there were higher incidences of bloody diarrhea (adjusted RR = 4.1, 95% CI: 1.1, 14.6), watery diarrhea (adjusted RR = 1.6, 95% CI: 0.9, 2.7), fast breathing (adjusted RR = 3.8, 95% CI: 2.1, 6.9), and the weekly point prevalence of pneumonia (adjusted prevalence ratio = 3.1, 95% CI: 1.0, 9.8) in measles cases during the same period. All measles cases regained lost weight within about 6 weeks. The prevalence of anergy to seven recall antigens 6 weeks after recruitment was higher in both hospital (adjusted odds ratio = 2.8, 95% CI: 1.2, 6.4) and community (adjusted odds ratio = 3.1, 95% CI: 1.1, 8.9) measles cases. Morbidity increased during the first 6-8 weeks after measles, but the authors found no consistent evidence of longer-term morbidity or wasting. The results support recent findings that measles is not associated with increased delayed mortality.
在1995年至1996年于孟加拉国达卡市开展的一项队列研究中,通过为期6个月的每周访谈,确定了117例住院麻疹病例和137例急性麻疹病例相对于年龄匹配的未患麻疹儿童(未暴露组)的发病率。与未暴露组儿童相比,住院麻疹病例在入组后的6周内住院率(调整率比(RR)= 3.1,95%置信区间(CI):1.3,7.6)和血性腹泻发生率(调整RR = 2.7,95% CI:1.4,5.1)更高。在社区队列中,同期麻疹病例的血性腹泻发生率(调整RR = 4.1,95% CI:1.1,14.6)、水样腹泻发生率(调整RR = 1.6,95% CI:0.9,2.7)、呼吸急促发生率(调整RR = 3.8,95% CI:2.1,6.9)以及肺炎的每周时点患病率(调整患病率比 = 3.1,95% CI:1.0,9.8)更高。所有麻疹病例在约6周内恢复了体重减轻。入组6周后,住院麻疹病例(调整优势比 = 2.8,95% CI:1.2,6.4)和社区麻疹病例(调整优势比 = 3.1,95% CI:1.1,8.9)对七种回忆抗原无反应的患病率更高。麻疹后的前6 - 8周发病率增加,但作者未发现长期发病或消瘦的一致证据。这些结果支持了近期的研究发现,即麻疹与延迟死亡率增加无关。