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[1993年至2015年间西班牙巴伦西亚一家参考医院儿科疟疾病例的描述性研究]

[Descriptive study of malaria cases in the paediatric population in a reference hospital in Valencia, Spain, between 1993 and 2015].

作者信息

Ramírez Cuentas John Helmut, Urtasun Erburu Andrea, Roselló Guijarro Mireia, Garrido Jareño Marta, Peman García Javier, Otero Reigada María Del Carmen

机构信息

Servicio de Pediatría, Hospital Quirón, Valencia, España; Servicio de Pediatría, Centro de Salud de Gandía, Gandía, Valencia, España.

Servicio de Pediatría, Hospital Universitario y Politécnico La Fe, Valencia, España.

出版信息

An Pediatr (Engl Ed). 2020 Jan;92(1):21-27. doi: 10.1016/j.anpedi.2019.03.008. Epub 2019 May 23.

Abstract

INTRODUCTION

Malaria is considered to be the fourth leading cause of infant mortality after pneumonia, complications related to premature birth, and perinatal asphyxia.

MATERIAL AND METHODS

A retrospective and descriptive study of cases of malaria confirmed and treated by the Paediatric Infectious Diseases Unit (age lower than 15 years) at the La Fe Hospital, Valencia, over the period 1993 to 2015.

RESULTS

A total of 54 cases of paediatric malaria were diagnosed in the period 1993-2015, with 51.8% of these occurring in males, and 46.2% of patients were aged below 5 years. The majority of children came from Equatorial Guinea (68.5%). Only 5.6% had received antimalarial prophylaxis. Plasmodium falciparum was found to be the causal species in 81.4% of cases. Seven patients (13%) presented with complicated malaria. The most widely used treatment was quinine, either alone or in combination with other drugs. Atovaquone/proguanil was used from 2010 onwards and was indicated in 20.3% of the patients. The combination of artesunate/piperaquine/dihydroartemisinin began to be used in 2013. No deaths or relevant side effects were reported, and the clinical response was favourable in all children (100%).

CONCLUSIONS

Malaria is still a prevalent disease in this population, a consequence of immigration, and tourism to endemic countries. Malaria should be considered as a likely diagnosis in a febrile child who comes from, or has travelled to, an endemic region in the past year.

摘要

引言

疟疾被认为是继肺炎、早产相关并发症和围产期窒息之后婴儿死亡的第四大主要原因。

材料与方法

对1993年至2015年期间在巴伦西亚拉费医院儿科传染病科确诊并治疗的疟疾病例(年龄低于15岁)进行回顾性描述性研究。

结果

1993年至2015年期间共诊断出54例儿童疟疾病例,其中51.8%为男性,46.2%的患者年龄在5岁以下。大多数儿童来自赤道几内亚(68.5%)。只有5.6%的人接受过抗疟预防。在81.4%的病例中发现恶性疟原虫是致病物种。7名患者(13%)出现复杂型疟疾。最常用的治疗方法是奎宁,单独使用或与其他药物联合使用。从2010年起开始使用阿托伐醌/氯胍,20.3%的患者使用了该药物。青蒿琥酯/哌喹/双氢青蒿素联合用药于2013年开始使用。未报告死亡或相关副作用,所有儿童的临床反应均良好(100%)。

结论

疟疾在这一人群中仍然是一种普遍存在的疾病,这是移民以及前往流行国家旅游的结果。对于过去一年来自或前往流行地区的发热儿童,应考虑疟疾为可能的诊断。

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