埃塞俄比亚阿法尔地区有症状个体中伤寒、斑疹伤寒、布鲁氏菌病和疟疾的社区流行率。
Community-based prevalence of typhoid fever, typhus, brucellosis and malaria among symptomatic individuals in Afar Region, Ethiopia.
机构信息
Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Microbiology Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
出版信息
PLoS Negl Trop Dis. 2018 Oct 4;12(10):e0006749. doi: 10.1371/journal.pntd.0006749. eCollection 2018 Oct.
BACKGROUND
In sub-Saharan Africa, where there is the scarcity of proper diagnostic tools, febrile illness related symptoms are often misdiagnosed as malaria. Information on causative agents of febrile illness related symptoms among pastoral communities in Ethiopia have rarely been described.
METHODS
In this a community based cross-sectional survey, we assessed the prevalence of typhoid fever, typhus, brucellosis and malaria among individuals with a set of given symptoms in Amibara district, Afar Region, Ethiopia. Blood samples were collected from 650 study participants, and examined by Widal and Weilfelix direct card agglutination test (DCAT) as well as test tube based titration test for Salmonella enterica serotype Typhi (S. Typhi) and Rickettsia infections. Rose Bengal Plate Test (RBPT) and Complement Fixation Test (CFT) were used to screen Brucella infection. Thin and thick blood smears were used to diagnosis malaria.
RESULTS
Out of 630 sera screened by DCAT, 83 (13.2%) were reactive to H and/or O antigens for S. Typhi infection. Among these, 46 (55.4%) were reactive by the titration test at the cut off value ≥ 1:80. The combined sero-prevalence for S. Typhi by the two tests was 7.3% (46/630). The seroprevalence for Rickettsia infection was 26.2% (165/630) by DCAT and 53.3% (88/165) by the titration test at the cut off value ≥ 1:80. The combined sero-prevalence for Rickettsia infection by the two tests was 14.0% (88/630). The sero-prevalence for Brucella infection was 12.7% (80/630) by RBPT, of which 28/80 (35%) were positive by CFT. The combined sero-prevalence for Brucella infection by the two tests was 4.4% (28/630). Out 650 suspected individuals for malaria, 16 (2.5%) were found positive for P. falciparum infection.
CONCLUSION
In this study, typhoid fever, typhus, brucellosis and malaria were observed among symptomatic individuals. The study also highlighted that brucellosis cases can be misdiagnosed as malaria or other disease based solely on clinical diagnosis. Therefore, efforts are needed to improve disease awareness and laboratory services for the diagnosis of brucellosis and other zoonotic diseases to identify other causes of febrile illness in this pastoral setting.
背景
在撒哈拉以南非洲地区，由于缺乏适当的诊断工具，发热相关症状常被误诊为疟疾。关于埃塞俄比亚牧民社区发热相关症状的病因，相关信息鲜有描述。
方法
在这项以社区为基础的横断面研究中，我们评估了在埃塞俄比亚阿法尔地区阿米巴拉地区，一组特定症状的个体中伤寒、斑疹伤寒、布鲁氏菌病和疟疾的患病率。采集了 650 名研究参与者的血液样本，并通过 Widal 和 Weilfelix 直接卡片凝集试验（DCAT）以及基于试管的肠沙门氏菌血清 Typhi（S. Typhi）和立克次体感染滴定试验进行检测。Rose Bengal 平板试验（RBPT）和补体固定试验（CFT）用于筛查布鲁氏菌感染。薄血涂片和厚血涂片用于诊断疟疾。
结果
在 630 份经 DCAT 筛查的血清中，有 83 份（13.2%）对 S. Typhi 感染的 H 和/或 O 抗原呈反应性。其中，46 份（55.4%）在截值≥1:80 的滴定试验中呈反应性。两种试验联合检测的 S. Typhi 血清阳性率为 7.3%（46/630）。通过 DCAT 检测，斑疹伤寒感染的血清阳性率为 26.2%（165/630），在截值≥1:80 时，通过滴定试验检测的血清阳性率为 53.3%（88/165）。两种试验联合检测的斑疹伤寒感染血清阳性率为 14.0%（88/630）。通过 RBPT 检测，布鲁氏菌感染的血清阳性率为 12.7%（80/630），其中 28/80（35%）对 CFT 呈阳性。两种试验联合检测的布鲁氏菌感染血清阳性率为 4.4%（28/630）。在 650 名疑似疟疾的个体中，有 16 名（2.5%）被发现感染恶性疟原虫。
结论
在这项研究中，在有症状的个体中观察到伤寒、斑疹伤寒、布鲁氏菌病和疟疾。该研究还强调，仅基于临床诊断，布鲁氏菌病病例可能被误诊为疟疾或其他疾病。因此，需要努力提高对布鲁氏菌病和其他人畜共患疾病的认识，并改善实验室服务，以诊断布鲁氏菌病和其他引起该牧区发热的疾病。
Zotero 插件