埃塞俄比亚一个小镇的肝静脉闭塞病的健康影响-2017 年提格雷地区塔特科罗罗区的病例研究。

Health impact of hepatic-venous-occlusive disease in a small town in Ethiopia-Case study from Tahtay koraro district in Tigray region, 2017.

机构信息

Mekelle University College of Health Science School of Public Health, Department of Epidemiology, Mekelle, Ethiopia.

Tigray Regional Health Bureaus, Mekelle, Ethiopia.

出版信息

PLoS One. 2019 Nov 5;14(11):e0224659. doi: 10.1371/journal.pone.0224659. eCollection 2019.

DOI:10.1371/journal.pone.0224659

PMID:31689340

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6831030/

Abstract

BACKGROUND

Hepatic venous-occlusive disease is blockage of microscopic veins in the liver causing 20-50% mortality. Ingestion of pyrrolizidine alkaloid plant, radiation therapy, and post-bone-marrow-transplant reactions are the commonest causes. In Ethiopia, a venous-occlusive disease outbreak was identified in 2002 in Tahtay Koraro district, Tigray. Suspected due to ingestion of the toxic pyrrolizidine alkaloid plant Ageratum conyzoids, found throughout the district. We aimed to describe the surveillance data of venous-occlusive disease from September 2006 to August 2016 in Tahtay koraro district, Ethiopia, 2017.

METHODOLOGY

We defined a possible Hepatic venous-occlusive disease case as any patient with abdominal pain for at least 2 weeks, abdominal distention, and hepato-splenomegaly during September 2006-August 2016. We reviewed previous district line lists, weekly reports, and clinical records to identify and describe cases. Agricultural interventions were obtained from the agricultural offices of the district.

RESULT

We identified 179 possible cases with 83 deaths with a case-fatality rate of 46.3%. Among cases, 110 (61.5%) were males and 113 (63%) were >15 years. In total, 164 (91.6%) cases were from one village (Kelakil). The pick number of cases of VOD in this village was during 2008/09 which was 1076. The highest incidence (86/100,000) occurred in 2008. During the study period, 2,746 years of potential life were lost due to Hepatic venous-occlusive disease. Mechanical removal of the Ageratum started in 2011.

CONCLUSION

Hepatic venous-occlusive disease was an ongoing problem in Tahtay Koraro; However, the problem has largely been alleviated by displacing people from the affected area and removing the causative weed. More research is needed to understand why Kelakil village was more affected despite the widespread presence of the weed. Chemical and mechanical removal of the Ageratum could strengthen intervention activities.

摘要

背景

肝静脉阻塞病是肝脏中小静脉阻塞导致 20-50%死亡率的疾病。摄入吡咯里西啶生物碱植物、放射治疗和骨髓移植后反应是最常见的原因。在埃塞俄比亚，2002 年提格雷的塔塔科拉罗区发生了静脉阻塞性疾病爆发。由于摄入了整个地区都存在的有毒吡咯里西啶生物碱植物灰绿藜，因此怀疑该病与此有关。我们旨在描述 2006 年 9 月至 2016 年 8 月在埃塞俄比亚塔塔科拉罗区静脉阻塞性疾病的监测数据，该研究于 2017 年进行。

方法

我们将任何有腹痛至少 2 周、腹部膨隆和肝脾肿大的患者定义为可能患有肝静脉阻塞性疾病病例。我们回顾了以前的区行列表、周报和临床记录，以识别和描述病例。农业干预措施来自区农业办公室。

结果

我们共发现了 179 例可能的病例，其中 83 例死亡，病死率为 46.3%。病例中，110 例（61.5%）为男性，113 例（63%）年龄>15 岁。总共 164 例（91.6%）病例来自一个村庄（Kelakil）。该村庄静脉阻塞性疾病病例的高发年份是 2008/09 年，有 1076 例。发病率最高的年份是 2008 年，发病率为 86/100,000。在研究期间，由于肝静脉阻塞性疾病，有 2746 人年的潜在寿命损失。2011 年开始对灰绿藜进行机械清除。