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[2004年塞内加尔达喀尔霍乱疫情:流行病学、临床及治疗方面]

[Cholera epidemic of 2004 in Dakar, Senegal: epidemiologic, clinical and therapeutic aspects].

作者信息

Ndour C T, Manga N M, Ká R, Dia-Badiane N M, Fortez L, Seydi M, Soumaré M, Sow A I, Diop B M, Sow P S

机构信息

Clinique des maladies infectieuses Ibrahima Diop Mar, Dakar, Sénégal.

出版信息

Med Trop (Mars). 2006 Feb;66(1):33-8.

Abstract

During the cholera epidemic that occurred in Dakar, Senegal in 2004, we treated a total of 593 confirmed or suspected cases in our department. The purpose of this report is to describe epidemiologic, clinical, bacteriologic and therapeutic aspects of these cases. Study was conducted at the infectious diseases clinic from October 11 to December 20, 2004. Mean patient age was 30 years and the sex ratio was 133. The likely source of contamination was food or water intake in 92% of cases. The duration of the epidemic was short (75 days). Onset was sudden in 98% of cases and the main clinical manifestations were watery diarrhoea (95%) and vomiting (78%). The mean delay between symptoms and hospitalization was 11 hours and the number of stools before admission to the hospital was greater than 10 in 23% of cases. At the time of admission 119 patients (20.1%) were severely dehydrated. A total of 250 coprocultures were performed. Results were positive in 145 cases (58%) including 112 (44%) for Vibrio cholerae 01. Antibiotic testing carried out on 36 strains demonstrated excellent sensitivity to doxycycine and pefloxacine but resistance to cotrimoxazole, amoxicilline and chloramphenicol. Oral rehydration therapy was used in most cases (61%). The mortality rate was 0.5%. Cholera is a medical emergency that can have a favourable prognosis with properly organized management.

摘要

在2004年塞内加尔达喀尔发生霍乱疫情期间,我们科室共治疗了593例确诊或疑似病例。本报告旨在描述这些病例的流行病学、临床、细菌学和治疗方面的情况。研究于2004年10月11日至12月20日在传染病诊所进行。患者平均年龄为30岁,男女比例为133。92%的病例可能的污染源是食物或水摄入。疫情持续时间较短(75天)。98%的病例起病突然,主要临床表现为水样腹泻(95%)和呕吐(78%)。症状出现至住院的平均间隔时间为11小时,23%的病例入院前排便次数超过10次。入院时119例患者(20.1%)严重脱水。共进行了250次粪便培养。145例(58%)结果呈阳性,其中112例(44%)为霍乱弧菌01型。对36株菌株进行的抗生素检测显示,对强力霉素和培氟沙星敏感性极佳,但对复方新诺明、阿莫西林和氯霉素耐药。大多数病例(61%)采用口服补液疗法。死亡率为0.5%。霍乱是一种医疗急症,通过合理组织管理可获得良好预后。

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