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伊朗西北部阿尔达比勒省的内脏利什曼病:一项回顾性流行病学、临床和辅助临床研究(1985 - 2018年)

Visceral Leishmaniasis in Ardabil Province, Northwest of Iran: A Retrospective Epidemiological, Clinical and Paraclinical Study (1985-2018).

作者信息

Molaei Soheila, Zandian Hamed, Molaie Akbar, Zahirian Telma, Mohebali Mehdi, Zareie Zabih, Nakhostin Babak, Emdadi Dariush, Akhoundi Behnaz, Modares-Sadrani Seyyedeh-Negar, Abdollahzadeh Hamed, Rakhshidan Zahra, Ezati Ezati, Heidari Zahra

机构信息

Zoonoses Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.

Deputy of Health, Ardabil University of Medical Sciences, Ardabil, Iran.

出版信息

Iran J Public Health. 2022 Aug;51(8):1875-1885. doi: 10.18502/ijph.v51i8.10274.

Abstract

BACKGROUND

We aimed to investigate the epidemiological, clinical and paraclinical aspects of Visceral Leishmaniasis in Ardabil Province, from 1986 to 2018.

METHODS

The disease has been diagnosed by a serological validate test as Direct Agglutination Test, parasitological methods, and clinical manifestations. The data were collected and then analyzed.

RESULTS

Overall, 2824 out of 69007cases (4.1%) had anti- antibodies at titers≥1:3200. The majority of VL cases belonged to Meshkin-Shahr, and then Germi County. The percentages of both male and female cases were 52.8 % and 46.6%, respectively. Approximately 78.1% of cases were less than 5 yr old. The high incidence rate of the disease was recorded in the years 1987 and 2003. 48.6%, 3.2%, and 1.9% of the patients had low titer (1:3200), high titer (1:102400), and suspicious titer (1:1600), respectively. Out of 1200 bone marrow aspiration, 23% were positive, and 77% were negative. Fever, paleness, and hepatosplenomegaly were the main symptoms in patients. Moreover, abdominal swelling, edema, weight loss, lymphadenopathy and jaundice were some other symptoms in the patients. Among biochemistry factors, the levels of aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, triglyceride and cholesterol have been increased. The death rate was estimated to be 2.8%, mainly related to the Ardabil and Germi cases.

CONCLUSION

Kala-Azar is still one of the most important infectious diseases in Ardabil Province, and is responsible for considerable death rate in infants. More attention should be done to parasite control and early diagnosis.

摘要

背景

我们旨在调查1986年至2018年阿尔达比勒省内脏利什曼病的流行病学、临床和辅助临床方面。

方法

该疾病通过血清学验证试验(直接凝集试验)、寄生虫学方法和临床表现进行诊断。收集数据后进行分析。

结果

总体而言,69007例病例中有2824例(4.1%)抗抗体滴度≥1:3200。大多数内脏利什曼病病例属于梅什金沙尔,其次是杰尔米县。男性和女性病例的百分比分别为52.8%和46.6%。约78.1%的病例年龄小于5岁。该疾病的高发病率记录在1987年和2003年。48.6%、3.2%和1.9%的患者抗抗体滴度较低(1:3200)、较高(1:102400)和可疑(1:1600)。在1200例骨髓穿刺中,23%为阳性,77%为阴性。发热、面色苍白和肝脾肿大是患者的主要症状。此外,腹部肿胀、水肿、体重减轻、淋巴结病和黄疸是患者的其他一些症状。在生化因素中,天冬氨酸转氨酶、丙氨酸转氨酶、乳酸脱氢酶、甘油三酯和胆固醇水平升高。死亡率估计为2.8%,主要与阿尔达比勒和杰尔米的病例有关。

结论

黑热病仍然是阿尔达比勒省最重要的传染病之一,并且导致婴儿死亡率相当高。应更加重视寄生虫控制和早期诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4272/9546796/d9ba873fbd85/IJPH-51-1875-g001.jpg

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