Asheville Eye Associates, Pediatric Ophthalmology, Asheville, North Carolina.
Department of Eye and Vision Science, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.
Am J Trop Med Hyg. 2018 Feb;98(2):516-519. doi: 10.4269/ajtmh.17-0506. Epub 2017 Dec 21.
Cerebral malaria (CM) is a significant cause of mortality and morbidity in sub-Saharan Africa, particularly among young children. Malarial retinopathy is the most specific clinical finding in CM, and fundus examination could help clinicians distinguish CM from other causes of encephalopathy in resource-poor areas. To assess clinician knowledge, practice patterns, and barriers to the use of funduscopy in the diagnosis of CM, we designed a descriptive multinational survey of clinicians in malaria endemic areas. Results of this survey showed that 19% of respondents were not aware of the utility of eye examinations for malarial retinopathy, and almost half (49%) never or almost never examine the eyes in cases of suspected CM. Educating clinicians about malarial retinopathy could be important in improving diagnostic specificity for CM.
脑型疟疾(CM)是撒哈拉以南非洲地区死亡率和发病率的重要原因,特别是在幼儿中。疟性视网膜病变是 CM 最具特异性的临床发现,眼底检查有助于临床医生在资源匮乏地区将 CM 与其他脑病病因区分开来。为了评估临床医生在 CM 诊断中使用眼底镜检查的知识、实践模式和障碍,我们设计了一项针对疟疾流行地区临床医生的描述性多国调查。这项调查的结果表明,19%的受访者不知道眼部检查对疟性视网膜病变的效用,近一半(49%)的人在疑似 CM 病例中从不或几乎从不检查眼睛。对临床医生进行疟性视网膜病变方面的教育可能对提高 CM 的诊断特异性很重要。