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印度北部一家三级护理教学医院的疟疾临床概况。

Clinical profile of malaria at a tertiary care teaching hospital in North India.

作者信息

Karoli Ritu, Shakya Shobhit, Gupta Nikhil, Mittal Vineeta, Upadhyay Anil Kumar

机构信息

Department of Medicine, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Department of Microbiology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

出版信息

Trop Parasitol. 2021 Jan-Jun;11(1):25-30. doi: 10.4103/tp.TP_76_20. Epub 2021 May 14.

Abstract

INTRODUCTION

Despite recent reductions in the overall malaria case incidence, malaria remains an important public health issue. There has been a change in clinical and epidemiological profile of malaria in our country and vivax malaria known to be benign has been reported to cause severe complications. Therefore, the present study was conducted to delineate the clinical profile of malaria, proportion of severity, spectrum of complications, and presence of comorbidities among adult patients admitted at a tertiary health-care center in North India.

MATERIALS AND METHODS

This was an observational prospective study conducted in all adult patients (>15 years of age) diagnosed to have Plasmodium vivax malaria, , and mixed malarial infection at a tertiary care teaching hospital on the basis of peripheral smear or rapid diagnostic tests.

RESULTS

The study included 295 patients, the most common species was vivax (62%) followed by falciparum (29%) and mixed plasmodium spp. (9%). The mean age of the patients was 34.23 ± 15.7 years, with 64% male and 36% female. Out of all patients, 23% patients had at least one component of severe malaria. Severe anemia (hemoglobin <5 mg/dl), thrombocytopenia (platelet count <1 lac/cmm), and acute kidney injury were significantly greater in patients with P. vivax. Presence of comorbid conditions was observed in a significant proportion (32%) of patients.

CONCLUSION

P. vivax is the plasmodium species which is responsible for most of the cases. Its potential to cause life-threatening illness is the cause of concern. The role of comorbid conditions in influencing the clinicaloutcome of malaria should be further explored.

摘要

引言

尽管近期疟疾总体发病率有所下降,但疟疾仍是一个重要的公共卫生问题。我国疟疾的临床和流行病学特征已发生变化,据报道,已知为良性的间日疟已引发严重并发症。因此,本研究旨在描绘印度北部一家三级医疗保健中心收治的成年疟疾患者的疟疾临床特征、严重程度比例、并发症谱以及合并症情况。

材料与方法

这是一项前瞻性观察性研究,纳入了所有在一家三级护理教学医院被诊断为间日疟原虫疟疾、 及混合疟原虫感染的成年患者(年龄>15岁),诊断依据为外周血涂片或快速诊断检测。

结果

该研究纳入了295名患者,最常见的疟原虫种类是间日疟原虫(62%),其次是恶性疟原虫(29%)和混合疟原虫种类(9%)。患者的平均年龄为34.23±15.7岁,男性占64%,女性占36%。在所有患者中,23%的患者至少有一项严重疟疾成分。间日疟原虫患者的严重贫血(血红蛋白<5mg/dl)、血小板减少(血小板计数<10万/cmm)和急性肾损伤明显更多。相当比例(32%)的患者存在合并症。

结论

间日疟原虫是导致大多数病例的疟原虫种类。其引发危及生命疾病的可能性令人担忧。合并症在影响疟疾临床结局中的作用应进一步探讨。

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