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[哥伦比亚安蒂奥基亚省乌拉瓦三个市非疟疾发热综合征的病因及流行病学特征]

[Etiology and epidemiological characterization of non-malarial febrile syndrome in three municipalities of Urabá (Antioquia), Colombia].

作者信息

Arroyave Esteban, Londoño Andrés Felipe, Quintero Juan Carlos, Agudelo-Flórez Piedad, Arboleda Margarita, Díaz Francisco J, Rodas Juan D

机构信息

Grupo Centauro, Universidad de Antioquia, Medellín, Colombia.

Instituto Colombiano de Medicina Tropical, Universidad CES, Medellín, Colombia.

出版信息

Biomedica. 2013 Sep;33 Suppl 1:99-107.

Abstract

INTRODUCTION

Urabá, a region on the northern coast of Colombia, is endemic to several acute febrile illnesses of infectious origin; however, only patients with malaria may have access to quick and effective diagnosis. For this reason, many non-malarial febrile patients go without a clear etiologic diagnosis.

AIM

To establish the etiology and clinical signs of acute febrile non-malaria syndromes and explore some of the likely risk factors in patients originating in the municipalities of Necocli, Turbo and Apartado who exhibit these symptoms.

MATERIALS AND METHODS

We obtained acute and convalescent sera from 220 non-malarial febrile patients from the rural and urban zones of Necocli, Turbo and Apartado during 2007 and 2008. Serologic tests for dengue (IgM by ELISA), leptospirosis (IgM and IgG by IFA), rickettsiosis (IgG by IFI), hanta and arenavirus (IgG by ELISA) were performed.

RESULTS

We found that the frequency of infection for dengue, leptospirosis, rickettsiosis and arenavirus, was 37.3%; 14.1%; 2.7% and 0.5%, respectively. There were 12 co-infection cases of leptospirosis-dengue and one of leptospirosis-rickettsiosis-dengue. Male gender and relative humidity were considered risk factors for dengue, and the beginning of clinical signs in February of 2008 was associated with the infection of dengue and leptospirosis.

CONCLUSION

This study confirms previous records that underline the importance of Rickettsia spp, dengue virus and Leptospira spp as causal agents of febrile syndrome in this region of Colombia.

摘要

引言

乌拉瓦是哥伦比亚北部海岸的一个地区,有几种传染性起源的急性发热性疾病流行;然而,只有疟疾患者能够获得快速有效的诊断。因此,许多非疟疾发热患者无法得到明确的病因诊断。

目的

确定急性非疟疾发热综合征的病因和临床体征,并探讨在表现出这些症状的内科克利、图尔沃和阿帕塔多市患者中一些可能的危险因素。

材料和方法

2007年至2008年期间,我们从内科克利、图尔沃和阿帕塔多市城乡的220名非疟疾发热患者中获取了急性期和恢复期血清。进行了登革热(ELISA法检测IgM)、钩端螺旋体病(IFA法检测IgM和IgG)、立克次体病(IFI法检测IgG)、汉坦病毒和沙粒病毒(ELISA法检测IgG)的血清学检测。

结果

我们发现登革热、钩端螺旋体病、立克次体病和沙粒病毒的感染率分别为37.3%、14.1%、2.7%和0.5%。有12例钩端螺旋体病-登革热合并感染病例,1例钩端螺旋体病-立克次体病-登革热合并感染病例。男性和相对湿度被认为是登革热的危险因素,2008年2月临床症状开始与登革热和钩端螺旋体病感染有关。

结论

本研究证实了先前的记录,强调了立克次体属、登革热病毒和钩端螺旋体属作为哥伦比亚该地区发热综合征病原体的重要性。

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