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[2005 - 2006年考卡山谷疟疾死亡率特征分析]

[Characterization of malaria mortality in Valle del Cauca, 2005-2006].

作者信息

Ernández Julián Alfredo, Osorio Lyda, Murillo Olga, Escobar Humberto, Bustamante Patricia, Agudelo Henry, Martínez Luz Patricia, Olaya Beatriz, Castro Gloria

机构信息

Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C, Colombia.

出版信息

Biomedica. 2009 Dec;29(4):582-90.

Abstract

INTRODUCTION

Valle del Cauca is one of the states in Colombia that reports a high number of deaths due to malaria. Understanding the basis of malarial deaths is useful for assessing the efficacy of the health system and to identify areas where improvements are necessary to decrease malaria mortality.

OBJECTIVE

Potential determinants of mortality in malaria cases are characterized in a demographic study centered in Valle del Cauca.

MATERIALS AND METHODS

A descriptive analysis was directed to 25 cases of malaria death occurring in Valle del Cauca during 2005 and 2006.

RESULTS

The mean age was 31.3 years (range, 2 to 71 yr), 11 were women (1 pregnant), 11 were from the malaria-endemic port of Buenaventura, and 5 from other Pacific coastal states. After entering the health system facility, the standard malaria diagnostic, the thick smear, was not ordered for 7 cases at any time during the treatment period. In cases where a thick smear was taken at first contact, 11 had a positive and 5 had a negative initial report. Cerebral malaria (7/18 cases) and renal failure (6/18 cases) were the most frequent complications. During hospitalization, 13/18 cases developed other complications, mainly acute lung edema (8/18 cases) and shock (5/18 cases).

CONCLUSIONS

Failures in primary health care of patients with malaria were recognized. This information has been used to implement actions aimed at improving initial care of malaria subjects in the health services of Valle del Cauca. The study recommends that other states in Colombia increase their efforts to decrease malaria mortality.

摘要

引言

考卡山谷是哥伦比亚报告疟疾死亡人数众多的州之一。了解疟疾死亡的根本原因有助于评估卫生系统的效力,并确定需要改进哪些方面以降低疟疾死亡率。

目的

在一项以考卡山谷为中心的人口统计学研究中,对疟疾病例死亡率的潜在决定因素进行特征描述。

材料与方法

对2005年和2006年在考卡山谷发生的25例疟疾死亡病例进行描述性分析。

结果

平均年龄为31.3岁(范围为2至71岁),11例为女性(1例怀孕),11例来自疟疾流行港口布埃纳文图拉,5例来自其他太平洋沿海州。进入卫生系统设施后,在治疗期间的任何时候,有7例患者未进行标准的疟疾诊断——厚涂片检查。在首次接触时进行厚涂片检查的病例中,11例初检报告为阳性,5例为阴性。脑型疟疾(7/18例)和肾衰竭(6/18例)是最常见的并发症。住院期间,18例中有13例出现其他并发症,主要是急性肺水肿(8/18例)和休克(5/18例)。

结论

已认识到疟疾患者初级卫生保健存在的不足。这些信息已被用于采取行动,旨在改善考卡山谷卫生服务中对疟疾患者的初始护理。该研究建议哥伦比亚其他州加大努力降低疟疾死亡率。

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