National Centre for Tropical Infectious Diseases, Haukeland University Hospital, Bergen, Norway.
BMC Infect Dis. 2009 Dec 15;9:206. doi: 10.1186/1471-2334-9-206.
A high rate of post-infectious fatigue and abdominal symptoms two years after a waterborne outbreak of giardiasis in Bergen, Norway in 2004 has previously been reported. The aim of this report was to identify risk factors associated with such manifestations.
All laboratory confirmed cases of giardiasis (n = 1262) during the outbreak in Bergen in 2004 received a postal questionnaire two years after. Degree of post-infectious abdominal symptoms and fatigue, as well as previous abdominal problems, was recorded. In the statistical analyses number of treatment courses, treatment refractory infection, delayed education and sick leave were used as indices of protracted and severe Giardia infection. Age, gender, previous abdominal problems and symptoms during infection were also analysed as possible risk factors. Simple and multiple ordinal logistic regression models were used for the analyses.
The response rate was 81% (1017/1262), 64% were women and median age was 31 years (range 3-93), compared to 61% women and 30 years (range 2-93) among all 1262 cases. Factors in multiple regression analysis significantly associated with abdominal symptoms two years after infection were: More than one treatment course, treatment refractory infection, delayed education, bloating and female gender. Abdominal problems prior to Giardia infection were not associated with post-infectious abdominal symptoms. More than one treatment course, delayed education, sick leave more than 2 weeks, and malaise at the time of infection, were significantly associated with fatigue in the multiple regression analysis, as were increasing age and previous abdominal problems.
Protracted and severe giardiasis seemed to be a risk factor for post-infectious fatigue and abdominal symptoms two years after clearing the Giardia infection.
2004 年挪威卑尔根市发生水源性贾第虫病暴发后，此前曾报道过感染后疲劳和腹部症状的发生率较高，且持续时间长达两年。本报告的目的是确定与这些表现相关的危险因素。
2004 年卑尔根暴发期间所有经实验室确诊的贾第虫病患者（n=1262）在感染两年后收到了一份邮寄问卷。记录感染后出现的腹部症状和疲劳的严重程度，以及之前的腹部问题。在统计分析中，使用治疗次数、治疗耐药感染、延迟教育和病假来作为贾第虫感染迁延和严重的指标。还分析了年龄、性别、以前的腹部问题和感染期间的症状等可能的危险因素。采用简单和多元有序逻辑回归模型进行分析。
应答率为 81%（1017/1262），女性占 64%，中位年龄为 31 岁（范围 3-93），而所有 1262 例患者中女性占 61%，年龄为 30 岁（范围 2-93）。多元回归分析中与感染两年后出现腹部症状显著相关的因素包括：治疗次数多于一次、治疗耐药感染、延迟教育、腹胀和女性。贾第虫感染前的腹部问题与感染后腹部症状无关。治疗次数多于一次、延迟教育、病假超过 2 周、感染时不适，与疲劳在多元回归分析中显著相关，而年龄增加和以前的腹部问题也是如此。
迁延性和严重的贾第虫病似乎是清除贾第虫感染两年后发生感染后疲劳和腹部症状的危险因素。
