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苏丹喀土穆州内脏利什曼病住院患者死亡的危险因素

Risk Factors of Inpatients Mortality of Visceral Leishmaniasis, Khartoum State, Sudan.

作者信息

Salih Omaima Abdel Majeed Mohamed, Nail Abdelsalam M, Modawe Gad Allah, Swar Mohamed Osman, Ahmed Mohamed H, Khalil Atif, Satti Abdelsalam Basheir, Abuzeid Nadir

机构信息

Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Omdurman Islamic University, Sudan.

Department of Internal Medicine, Faculty of Medicine and Health Sciences, Omdurman Islamic University, Sudan.

出版信息

J Glob Infect Dis. 2020 Aug 29;12(3):135-140. doi: 10.4103/jgid.jgid_25_20. eCollection 2020 Jul-Sep.

Abstract

BACKGROUND

Visceral leishmaniasis (VL) is one of the common infections in Sudan and can be associated with an increase in morbidity and mortality. The aim of this study was to assess the risk factors associated with mortality and morbidity with VL.

MATERIALS AND METHODS

This is a cross-sectional hospital-based study that recruited 150 patients with VL from two centers in Khartoum. Secondary data were extracted from the patient records, and data were analyzed using SPSS version 24.0.

RESULTS

The study included 2.5% of infants, 39.4% children, and 58% of adults. Male represents 77.3% of the cohort, and total mortality was 16%. Among the death reported 12.5% in infants, 16.7% were children, and 70.8% were in adults. Laboratory parameters significantly associated with mortality in univariate analysis were low white cell count, low platelets, high creatinine, and high liver enzymes. While risk factors such as infant, male, acquired infection from Eastern Sudan or White Nile, weight loss, morbid diseases, and concomitant bacterial infections were also associated with significant mortality in univariate analysis. Importantly, logistic regression analysis revealed significant association with infant ( = 0.02), concomitant bacterial infections ( = 0.003), comorbid disease ( = 0.001), low total blood cell count ( = 0.018), low platelets ( = 0.013), and high aspartate transaminase/alanine aminotransferase ( = 0.013).

CONCLUSION

Health education and awareness are needed in terms of prevention and control, especially with high mortality seen in the infant. Treatment of underlying co-morbid diseases and bacterial infections are important to enhance survival. Patients with Leishmania are vulnerable; therefore, regular routine blood tests are an essential part of management to manage complications such as renal, hepatic failure, or severe anemia.

摘要

背景

内脏利什曼病(VL)是苏丹常见的感染之一,可导致发病率和死亡率上升。本研究旨在评估与VL死亡率和发病率相关的危险因素。

材料与方法

这是一项基于医院的横断面研究,从喀土穆的两个中心招募了150例VL患者。从患者记录中提取二手数据,并使用SPSS 24.0版进行数据分析。

结果

该研究纳入了2.5%的婴儿、39.4%的儿童和58%的成年人。男性占队列的77.3%,总死亡率为16%。在报告的死亡病例中,婴儿占12.5%,儿童占16.7%,成年人占70.8%。单因素分析中与死亡率显著相关的实验室参数为白细胞计数低、血小板低、肌酐高和肝酶高。而婴儿、男性、从苏丹东部或白尼罗河获得感染、体重减轻、疾病、合并细菌感染等危险因素在单因素分析中也与显著死亡率相关。重要的是,逻辑回归分析显示与婴儿(P = 0.02)、合并细菌感染(P = 0.003)、合并疾病(P = 0.001)、全血细胞计数低(P = 0.018)、血小板低(P = 0.013)和天冬氨酸转氨酶/丙氨酸转氨酶高(P = 0.013)有显著关联。

结论

在预防和控制方面需要进行健康教育和提高认识,特别是鉴于婴儿中观察到的高死亡率。治疗潜在的合并疾病和细菌感染对于提高生存率很重要。利什曼病患者很脆弱;因此,定期进行常规血液检查是管理的重要组成部分,以处理诸如肾衰竭、肝衰竭或严重贫血等并发症。

相似文献

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Leishmaniasis in Sudan. Visceral leishmaniasis.苏丹的利什曼病。内脏利什曼病。
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