Hatami Hossein, Qaderi Shohra, Omid Ahmad Murad
Department of Public Health, School of Public Health and Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Communicable Disease, Kabul Antani Hospital, Ministry of Public Health, Kabul, Afghanistan.
Int J Prev Med. 2019 Jul 5;10:117. doi: 10.4103/ijpvm.IJPVM_391_18. eCollection 2019.
Crimean-Congo hemorrhagic fever (CCHF) is the most medically significant hemorrhagic fever. Afghanistan as an endemic region of CCHF has shown a rapidly growing incidence of the CCHF recently, but there is no data on the characteristic of the disease in this country, here we study the epidemiological, clinical, and paraclinical features of this disease in patients with CCHF, based on the collected data from the patients document records from March 2017 to January 2018 in the referral infectious diseases hospital of Afghanistan (Kabul Antani Hospital).
A cross-sectional study in 120 patients admitted in Kabul ANTANI hospital was carried out from March 2017 to January 2018. All of the patients were included based on the standard case definitions by World Health Organization.
Among the 120 patients admitted to CCHF ward, 29 were confirmed by ELISA (18% IgM, 8% IgG+) and the reminders defined as "probable cases" according to WHO case definition. Case fatality rates were calculated as 15% and the overall mean ages were 35 years. The peak of the disease incidence occurred between August and July. Almost all patients reported fever, bleeding, and thrombocytopenia.
Early detection plays an important role in patients' outcome. Considering that the most cases of the disease are associated with some contacts around Eid-Adha and death attributable to CCHF usually occur in the first 7 days of disease onset, educating population, and especially slaughters, gloves using by housewives during contacts with meat or animal products, and early detection and immediate treatment would have essential roles in primary and secondary prevention of CCHF. Hemorrhagic manifestations and low platelet count provide a clue to early detection of disease. Vaginal bleeding can be a sign of CCHF and needs immediate action.
克里米亚-刚果出血热（CCHF）是医学上最重要的出血热。阿富汗作为CCHF的流行地区，近期CCHF发病率呈快速上升趋势，但该国尚无关于该疾病特征的数据。在此，我们基于2017年3月至2018年1月在阿富汗转诊传染病医院（喀布尔安塔尼医院）收集的患者病历记录，研究CCHF患者的流行病学、临床和辅助临床特征。
2017年3月至2018年1月在喀布尔安塔尼医院对120例住院患者进行了横断面研究。所有患者均根据世界卫生组织的标准病例定义纳入。
在120例入住CCHF病房的患者中，29例通过酶联免疫吸附测定法确诊（18% IgM、8% IgG+），其余根据世界卫生组织病例定义被定义为“疑似病例”。计算得出病死率为15%，总体平均年龄为35岁。疾病发病率高峰出现在8月至7月之间。几乎所有患者均报告有发热、出血和血小板减少。
早期发现对患者的预后起着重要作用。鉴于该疾病的大多数病例与宰牲节前后的一些接触有关，且CCHF导致的死亡通常发生在发病后的前7天，对公众进行教育，尤其是对屠宰人员、家庭主妇在接触肉类或动物产品时使用手套进行教育，以及早期发现和立即治疗在CCHF的一级和二级预防中具有重要作用。出血表现和低血小板计数为疾病的早期发现提供了线索。阴道出血可能是CCHF的一个迹象，需要立即采取行动。
