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初诊为登革热患者中的钩端螺旋体病患病率。

Leptospirosis prevalence in patients with initial diagnosis of dengue.

机构信息

Coordinación de Vigilancia Epidemiológica y Apoyo en Contingencias, Unidad de Salud Pública, Instituto Mexicano del Seguro Social (IMSS), 03100, Mexico City, DF, Mexico.

出版信息

J Trop Med. 2012;2012:519701. doi: 10.1155/2012/519701. Epub 2012 Apr 24.

Abstract

Objective. To determine the prevalence of leptospirosis in patients from Veracruz with initial diagnosis of dengue and its association with risk factors. Materials and Methods. Transversal study in patients who sought medical attention under the suspicion of dengue. Backgrounds were researched and blood samples were drawn to determine dengue (NS1, RT-PCR) and leptospirosis (IFI). Simple frequencies, central tendency and dispersion measures, and prevalence and trust intervals at 95% (IC95%) were obtained. Prevalence reasons (RP) and IC(95%) were obtained and a multivariate logistic model was applied, using SPSS V15. Results. 171 patients were included, 56% women (32 ± 14 years) and 44% men (32 ± 17 years). 48% of the cases (IC95% 40.5-55.4) was positive to dengue, with a cut point of 1 : 80, seroprevalence for leptospirosis was of 6% (IC(95%) 2.7-10); 12% (IC95% 7-16.5) was positive to both pathologies and 34% was negative to both tests. Although the largest number of isolations corresponded to serotype 2, the four dengue virus serotypes were identified. In the bivariate analysis, overcrowding RP = 1.33, (IC = 0.46-3.5), bathing in rivers (RP = 1.31, IC = 0.13-7.4), and walking barefoot (RP = 1.39, IC = 0.58-3.3) were the variables associated with leptospirosis, although the relation was not statistically significant. Conclusions. Leptospirosis prevalence in subjects under suspicion of dengue fever is high, as well as the coincidence of both infections. The results show the coexistence of overlapped outbreaks of several diseases sharing the side of transmission. It is necessary the intentional search of other pathologies, such as influenza, rickettsiosis, and brucella, among others.

摘要

目的。确定初始诊断为登革热的韦拉克鲁斯患者中钩端螺旋体病的流行情况及其与危险因素的关系。

材料和方法。对疑似登革热患者进行横断面研究。研究背景并抽取血样以确定登革热(NS1、RT-PCR)和钩端螺旋体病(IFI)。获得简单频率、集中趋势和离散度量、流行率和 95%置信区间(95%CI)。获得流行率原因(RP)和 95%CI(RP),并使用 SPSS V15 应用多变量逻辑模型。

结果。共纳入 171 例患者,其中 56%为女性(32 ± 14 岁),44%为男性(32 ± 17 岁)。48%的病例(95%CI 40.5-55.4)对登革热呈阳性,检测值为 1:80,钩端螺旋体病的血清流行率为 6%(95%CI(2.7-10));12%(95%CI 7-16.5)两种病原体均呈阳性,34%两者均呈阴性。虽然分离的菌株数量最多的是血清型 2,但也鉴定了四种登革热病毒血清型。在单变量分析中,过度拥挤的流行率比(RP)为 1.33(IC = 0.46-3.5),在河中洗澡(RP)为 1.31(IC = 0.13-7.4),赤脚走路(RP)为 1.39(IC = 0.58-3.3)是与钩端螺旋体病相关的变量,尽管这一关系没有统计学意义。

结论。在疑似登革热患者中,钩端螺旋体病的流行率较高,两种感染同时存在。结果表明,几种具有重叠传播途径的疾病同时暴发。有必要有意寻找其他疾病,如流感、立克次体病和布鲁氏菌病等。

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