Carme B, Sobesky M, Joubert M, Egmann G, Cotellon P
Equipe JE 21-88, UFR médecine Antilles-Guyane.
Bull Soc Pathol Exot. 2000 Feb;93(1):46-9.
A retrospective study was carried out in the General Hospital of Cayenne, the main city in French Guiana, where malaria is endemic and dengue fever constitutes a permanent threat. The aim of this study was to test an alert system for epidemic outbreaks of dengue fever. Patients attending the emergency ward and for whom a search of Plasmodium was prescribed were included. In 90% of cases, patients were febrile, presenting clinical symptoms compatible with malaria or dengue fever-like syndrome. The period of survey covered 39 months (January 1996 to March 1999). Three indices were studied; two non specific: EMN (Emergency Malaria Negative--UPN in French): number of negative malaria blood tests for patients having consulted the emergency ward; EMNT (Emergency Malaria Negative Thrombopenia--UPNT in French): UPN with platelets < 150.000; and one more specific; number of hospitalised dengue fever cases according to data from a hospital programme on medical systems information. EMN weekly follow-ups led to three epidemic alerts, two of which turned out to be crucial for dengue. Accounting for thrombopenia (EMNT) reinforced the specificity. This simple and reactive alert system should incite increased serological and virological surveillance and contribute to precocious antivectorial control measures in districts where several dengue fever cases are suspected.
在法属圭亚那的主要城市卡宴总医院开展了一项回顾性研究，该地疟疾流行，登革热构成持续威胁。本研究的目的是测试一种登革热疫情警报系统。纳入了前往急诊病房就诊且被要求检测疟原虫的患者。90%的病例中，患者发热，呈现出与疟疾或登革热样综合征相符的临床症状。调查期涵盖39个月（1996年1月至1999年3月）。研究了三个指标；两个非特异性指标：EMN（急诊疟疾阴性——法语为UPN）：前往急诊病房就诊患者的疟疾血检阴性数量；EMNT（急诊疟疾阴性伴血小板减少——法语为UPNT）：血小板<150,000的UPN；以及一个更具特异性的指标：根据医院医疗系统信息项目数据得出的住院登革热病例数。EMN的每周随访引发了三次疫情警报，其中两次对登革热而言至关重要。考虑血小板减少（EMNT）增强了特异性。这种简单且具有反应性的警报系统应促使加强血清学和病毒学监测，并有助于在疑似有几例登革热病例的地区采取早熟的病媒控制措施。
