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斯里兰卡利什曼病流行区一个肾脏科的肾病患者接触寄生虫风险评估

Assessment of Risk of Exposure to Parasites among Renal Disease Patients from a Renal Unit in a Sri Lankan Endemic Leishmaniasis Focus.

作者信息

Menike Chandrani, Dassanayake Rajeewa, Wickremasinghe Renu, Seneviwickrama Maheeka, De Alwis Indika, Abd El Wahed Ahmed, Ranasinghe Shalindra

机构信息

Department of Parasitology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda 10280, Sri Lanka.

Nephrology Unit, Teaching Hospital, Anuradhapura 50000, Sri Lanka.

出版信息

Pathogens. 2022 Dec 16;11(12):1553. doi: 10.3390/pathogens11121553.

Abstract

causes both cutaneous and visceral leishmaniasis (CL and VL) in Sri Lanka, where chronic kidney disease (CKD) and kidney transplant recipients' (KTR) geographical areas overlap. This study aimed to determine the risk of exposure to infection among renal patients. This cross-sectional study in a renal unit assessed clinical symptoms and signs of CL and VL in recipients of blood/kidney or immunosuppressives. Sera were tested with -specific DAT and rK-39 ELISA. There were 170 participants. A total of 84.1% (n = 143) were males (CKD: 101, KTR; 42, mean age 45) and 27 were females (females: CKD: 23, KTR: 4, mean age 39 years). Recipients of blood transfusion/s within last 2 years: 75.9% (CKD: 115, KTR: 14), on immunosuppressive therapy: 34.1% (CKD: 13, KTR: 45). Two CKD patients repeatedly showed clear positive titres (1: 12,800 and 1: 3200) with -DAT and another two (CKD) became marginally positive with rK39-ELISA. Prevalence of anti- antibodies: 2.4% (4/170). All four patients were clinically asymptomatic and were recipients of recent blood transfusions. Attributable risk of exposure to infection through blood transfusions was 0.032, OR 2.99 (95% CI = 0.16 to 56.45, = 0.47). Therefore, routine screening of kidney/blood donors and CKD and KTR patients in Sri Lanka may not be necessary.

摘要

在斯里兰卡,慢性肾病(CKD)和肾移植受者(KTR)的地理区域重叠,[某种病原体]会引发皮肤利什曼病和内脏利什曼病(CL和VL)。本研究旨在确定肾病患者接触[该病原体]感染的风险。在一个肾脏科室进行的这项横断面研究评估了接受血液/肾脏或免疫抑制剂治疗的患者中CL和VL的临床症状和体征。采用特异性直接凝集试验(DAT)和重组抗原K39酶联免疫吸附测定(rK-39 ELISA)检测血清。共有170名参与者。其中84.1%(n = 143)为男性(CKD患者101名,KTR患者42名,平均年龄45岁),27名女性(CKD患者23名,KTR患者4名,平均年龄39岁)。过去2年内接受过输血的患者:75.9%(CKD患者115名,KTR患者14名),接受免疫抑制治疗的患者:34.1%(CKD患者13名,KTR患者45名)。两名CKD患者的DAT检测反复显示明确的阳性滴度(1:12,800和1:3200),另外两名(CKD患者)的rK39-ELISA检测呈弱阳性。抗[该病原体]抗体的患病率为2.4%(4/170)。所有4名患者临床无症状,且均为近期输血受者。通过输血接触[该病原体]感染的归因风险为[X],比值比(OR)为2.99(95%置信区间 = 0.16至56.45,P = 0.47)。因此,在斯里兰卡对肾脏/血液捐献者以及CKD和KTR患者进行常规筛查可能没有必要。 (注:原文中“causes both cutaneous and visceral leishmaniasis (CL and VL) in Sri Lanka, where chronic kidney disease (CKD) and kidney transplant recipients' (KTR) geographical areas overlap.”部分,未明确指出具体病原体,翻译时保留原文表述方式;“Attributable risk of exposure to infection through blood transfusions was 0.032”中“0.032”后原文缺失内容,翻译时保留原文形式。)

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