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[巴布亚新几内亚疟疾患者不同临床标准的分析]

[Analysis of different clinical criteria in malaria patients in Papua New Gwinea].

作者信息

Rehlis N, Kurczewska M

机构信息

Klinika Chorób Pasozytniczych i Tropikalnych AM, 60-355 Poznań, ul. Przybyszewskiego 49.

出版信息

Wiad Parazytol. 2001;47(3):371-6.

Abstract

To assess the validity of different clinical criteria in malaria patients, a small study including 92 children presented with fever or history of fever were examined in a highly endemic area of Papua New Gwinea. In 21 children parasitaemia was confirmed by microscopy examination of thick and thin smear stained with Giemsa method (9 cases of Plasmodium falciparum, 8 cases of Plasmodium vivax and 4 cases of mixed invasion Plasmodium falciparum and Plasmodium vivax). Only 4 from different 39 criteria analyzed in children with history of fever or hot skin showed significant association with parasitaemia (conscious disturbances, severe wasting, enlarged spleen and diarrhoea), however none of the criteria presented high sensitivity and could serve as good predictors for parasitaemia accept two (first and second one). These findings help to realize the importance of laboratory examination in diagnosis of malaria and explain difficulties in confirming or exclusion of malaria where microscopy is not available.

摘要

为评估不同临床标准在疟疾患者中的有效性,在巴布亚新几内亚一个疟疾高度流行地区,对一项纳入92名有发热或发热史儿童的小型研究进行了检查。通过吉姆萨染色法对厚薄涂片进行显微镜检查,确诊21名儿童存在寄生虫血症(9例恶性疟原虫、8例间日疟原虫以及4例恶性疟原虫和间日疟原虫混合感染)。在有发热史或皮肤发热的儿童中分析的39项标准里,仅有4项与寄生虫血症存在显著关联(意识障碍、严重消瘦、脾脏肿大和腹泻),然而,除了两项标准(第一项和第二项)外,没有一项标准具有高敏感性,也不能作为寄生虫血症的良好预测指标。这些发现有助于认识实验室检查在疟疾诊断中的重要性,并解释了在无法进行显微镜检查的情况下确诊或排除疟疾的困难。

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