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马来西亚东北部基于医院的发热病例中钩端螺旋体病血清流行率研究。

A hospital-based study on seroprevalence of leptospirosis among febrile cases in northeastern Malaysia.

机构信息

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.

出版信息

Int J Infect Dis. 2013 Jun;17(6):e394-7. doi: 10.1016/j.ijid.2012.12.012. Epub 2013 Jan 26.

Abstract

OBJECTIVE

To determine the seroprevalence of leptospirosis among febrile inpatient cases in northeastern Malaysia.

METHODS

A hospital-based cross-sectional study was conducted among 999 febrile cases admitted to 10 hospitals in northeastern Malaysia. A survey using a proforma sheet was used to obtain sociodemographic and occupational information. Serum samples were screened for leptospirosis by IgM enzyme-linked immunosorbent assay test (IgM ELISA) and confirmed by microscopic agglutination test (MAT).

RESULTS

There was an equivalent distribution of males and females in the 999 respondents enrolled in the study. The majority were Malay (94.7%) and their mean age was 39.4 (standard deviation 17.6) years. The overall seroprevalence of leptospirosis was 8.4% (95% confidence interval (CI) 6.8-10.3) (n=84). The high-risk occupational group was found to have a higher seroprevalence, which was 56% (95% CI 45.3-66.1) (n=47). The predominant serogroup was Sejroe (82.1%, 95% CI 72.6-88.8) (n=69).

CONCLUSIONS

This study revealed a possible high seroprevalence of leptospirosis among febrile cases, indicating the need to review the importance of adding leptospirosis to the case investigation of febrile illness, especially among high-risk occupational groups in Malaysia, as well as in other endemic countries.

摘要

目的

确定马来西亚东北部发热住院病例中钩端螺旋体病的血清流行率。

方法

对马来西亚东北部 10 家医院的 999 例发热住院患者进行了一项基于医院的横断面研究。使用表格形式的调查获取社会人口学和职业信息。使用 IgM 酶联免疫吸附试验(IgM ELISA)和显微镜凝集试验(MAT)筛查血清样本中的钩端螺旋体病。

结果

在纳入研究的 999 名受访者中,男性和女性的分布相当。大多数是马来人(94.7%),平均年龄为 39.4(标准差 17.6)岁。钩端螺旋体病的总血清流行率为 8.4%(95%置信区间(CI)为 6.8-10.3)(n=84)。发现高风险职业群体的血清流行率较高,为 56%(95%CI 为 45.3-66.1)(n=47)。主要血清群为赛罗(82.1%,95%CI 为 72.6-88.8)(n=69)。

结论

本研究表明发热病例中可能存在较高的钩端螺旋体病血清流行率,这表明需要重新评估将钩端螺旋体病纳入发热病病例调查的重要性,尤其是在马来西亚和其他流行地区的高风险职业群体中。

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