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印度阿里格尔疟疾的患病率及临床表现

Prevalence and clinical manifestations of malaria in Aligarh, India.

作者信息

Asma Umm-e, Taufiq Farha, Khan Wajihullah

机构信息

Department of Zoology, Aligarh Muslim University, Aligarh 202002, India.

出版信息

Korean J Parasitol. 2014 Dec;52(6):621-9. doi: 10.3347/kjp.2014.52.6.621. Epub 2014 Dec 23.

Abstract

Malaria is one of the most widespread infectious diseases of tropical countries with an estimated 207 million cases globally. In India, there are endemic pockets of this disease, including Aligarh. Hundreds of Plasmodium falciparum and P. vivax cases with severe pathological conditions are recorded every year in this district. The aim of this study is to find out changes in liver enzymes and kidney markers. Specific diagnosis for P. falciparum and P. vivax was made by microscopic examination of Giemsa stained slides. Clinical symptoms were observed in both of these infections. Liver enzymes, such as AST, ALT, and ALP, and kidney function markers, such as creatinine and urea, were estimated by standard biochemical techniques. In Aligarh district, P. vivax, P. falciparum, and mixed infections were 64%, 34%, and 2%, respectively. In case of P. falciparum infection, the incidences of anemia, splenomegaly, renal failure, jaundice, and neurological sequelae were higher compared to those in P. vivax infection. Recrudescence and relapse rates were 18% and 20% in P. falciparum and P. vivax infections, respectively. Liver dysfunctions and renal failures were more common in P. falciparum patients, particularly in elderly patients. Artesunate derivatives must, therefore, be introduced for the treatment of P. falciparum as they resist to chloroquine as well as sulfadoxine-pyrimethamine combinations.

摘要

疟疾是热带国家最普遍的传染病之一,全球估计有2.07亿病例。在印度,包括阿里格尔在内,存在这种疾病的地方性疫源地。该地区每年记录有数百例患有严重病理状况的恶性疟原虫和间日疟原虫病例。本研究的目的是找出肝酶和肾脏标志物的变化。通过对吉姆萨染色玻片进行显微镜检查对恶性疟原虫和间日疟原虫进行特异性诊断。在这两种感染中均观察到临床症状。采用标准生化技术测定肝酶,如谷草转氨酶、谷丙转氨酶和碱性磷酸酶,以及肾功能标志物,如肌酐和尿素。在阿里格尔地区,间日疟原虫、恶性疟原虫和混合感染分别为64%、34%和2%。在恶性疟原虫感染病例中,贫血、脾肿大、肾衰竭、黄疸和神经后遗症的发生率高于间日疟原虫感染病例。恶性疟原虫和间日疟原虫感染的复发率分别为18%和20%。肝功能障碍和肾衰竭在恶性疟原虫患者中更为常见,尤其是老年患者。因此,必须引入青蒿琥酯衍生物来治疗恶性疟原虫,因为它们对氯喹以及磺胺多辛-乙胺嘧啶联合用药具有抗性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65df/4277024/ee124c59682d/kjp-52-621-g001.jpg

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