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疟疾感染儿童的血液学参数、含疟色素白细胞及其与疾病严重程度的关联:埃塞俄比亚西北部帕韦综合医院的一项横断面研究

Hematological Parameters and Hemozoin-Containing Leukocytes and Their Association with Disease Severity among Malaria Infected Children: A Cross-Sectional Study at Pawe General Hospital, Northwest Ethiopia.

作者信息

Birhanu Muluken, Asres Yaregal, Adissu Wondimagegn, Yemane Tilahun, Zemene Endalew, Gedefaw Lealem

机构信息

Department of Medical Laboratory Science, Assosa University, Assosa, Ethiopia.

Department of Medical Laboratory Science and Pathology, College of Health Sciences, Jimma University, Jimma, Ethiopia.

出版信息

Interdiscip Perspect Infect Dis. 2017;2017:8965729. doi: 10.1155/2017/8965729. Epub 2017 Feb 19.

Abstract

Hematological parameter changes are the most common complications in malaria. We aimed to determine the hematological parameters and hemozoin-containing leukocytes and their association with disease severity in malaria infected children aged between 1 and 15 years. A facility-based cross-sectional study was conducted at Pawe General Hospital from July 31 to December 30, 2014. Demographic and clinical data were collected using structured questionnaire. Blood specimen was collected from each study participant for hematological investigations. Data were analyzed using SPSS version 20. The overall prevalence of anemia was 40.3%, most of which were mildly anemic. Leukocytosis was found in 15.4% of study participants. More than a fourth (27%) of the children had severe malaria. Hemozoin-containing monocytes and neutrophils were found in 80.1% and 58.9% of the study participants, respectively. Under-five years of age (AOR = 3.01, 95% CI: 1.83-7.39, < 0.001), leukocytosis (AOR = 3.20, 95% CI: 1.65-6.24, = 0.001), mean hemozoin-containing monocytes >5% (AOR = 6.26, 95% CI: 2.14-14.29, < 0.001), mean hemozoin-containing neutrophils >5% (AOR = 7.93, 95% CI: 3.09-16.86, < 0.001), and high density parasitemia (AOR = 1.90, 95% CI: 1.13-3.18, = 0.015) were associated with severe malaria. Hemozoin-containing leukocytes, leukocytosis, and other identified associated factors should be considered for proper management of children with severe malaria.

摘要

血液学参数变化是疟疾最常见的并发症。我们旨在确定1至15岁疟疾感染儿童的血液学参数、含疟原虫色素的白细胞及其与疾病严重程度的关联。2014年7月31日至12月30日在帕韦综合医院进行了一项基于机构的横断面研究。使用结构化问卷收集人口统计学和临床数据。从每个研究参与者采集血液样本进行血液学检查。使用SPSS 20版分析数据。贫血的总体患病率为40.3%,其中大多数为轻度贫血。15.4%的研究参与者出现白细胞增多。超过四分之一(27%)的儿童患有严重疟疾。分别在80.1%和58.9%的研究参与者中发现了含疟原虫色素的单核细胞和中性粒细胞。五岁以下(比值比=3.01,95%置信区间:1.83 - 7.39,P<0.001)、白细胞增多(比值比=3.20,95%置信区间:1.65 - 6.24,P = 0.001)、平均含疟原虫色素的单核细胞>5%(比值比=6.26,95%置信区间:2.14 - 14.29,P<0.001)、平均含疟原虫色素的中性粒细胞>5%(比值比=7.93,95%置信区间:3.09 - 16.86,P<0.001)以及高密度寄生虫血症(比值比=1.90,95%置信区间:1.13 - 3.18,P = 0.015)与严重疟疾相关。对于严重疟疾患儿的适当管理,应考虑含疟原虫色素的白细胞、白细胞增多及其他已确定的相关因素。

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