Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
Clin Infect Dis. 2023 Sep 11;77(5):721-728. doi: 10.1093/cid/ciad262.
The northwestern border of Thailand is an area of low seasonal malaria transmission. Until recent successful malaria elimination activities, malaria was a major cause of disease and death. Historically the incidences of symptomatic Plasmodium falciparum and Plasmodium vivax malaria were approximately similar.
All malaria cases managed in the Shoklo Malaria Research Unit along the Thailand-Myanmar border between 2000 and 2016 were reviewed.
There were 80 841 consultations for symptomatic P. vivax and 94 467 for symptomatic P. falciparum malaria. Overall, 4844 (5.1%) patients with P. falciparum malaria were admitted to field hospitals, of whom 66 died, compared with 278 (0.34%) with P. vivax malaria, of whom 4 died (3 had diagnoses of sepsis, so the contribution of malaria to their fatal outcomes is uncertain). Applying the 2015 World Health Organization severe malaria criteria, 68 of 80 841 P. vivax admissions (0.08%) and 1482 of 94 467 P. falciparum admissions (1.6%) were classified as severe. Overall, patients with P. falciparum malaria were 15 (95% confidence interval, 13.2-16.8) times more likely than those with P. vivax malaria to require hospital admission, 19 (14.6-23.8) times more likely to develop severe malaria, and ≥14 (5.1-38.7) times more likely to die.
In this area, both P. falciparum and P. vivax infections were important causes of hospitalization, but life-threatening P. vivax illness was rare.
泰国西北部边境地区疟疾季节性传播水平较低。直到最近成功开展消除疟疾活动之前，疟疾一直是主要的疾病和死亡原因。历史上，有症状的恶性疟原虫和间日疟原虫疟疾的发病率大致相似。
回顾了 2000 年至 2016 年期间在泰国-缅甸边境的肖克隆疟疾研究单位管理的所有有症状的间日疟原虫和恶性疟原虫疟疾病例。
共有 80841 例有症状的间日疟原虫和 94467 例有症状的恶性疟原虫疟疾患者就诊。总体而言，4844 例（5.1%）恶性疟原虫疟疾患者被收入野战医院，其中 66 例死亡，而 278 例（0.34%）间日疟原虫疟疾患者中，有 4 例死亡（3 例诊断为败血症，因此疟疾对其致死结局的贡献不确定）。应用 2015 年世界卫生组织重症疟疾标准，80841 例间日疟原虫住院患者中有 68 例（0.08%）和 94467 例恶性疟原虫住院患者中有 1482 例（1.6%）被归类为重症。总体而言，恶性疟原虫疟疾患者需要住院治疗的可能性是间日疟原虫疟疾患者的 15 倍（95%置信区间，13.2-16.8），发展为重症疟疾的可能性是间日疟原虫疟疾患者的 19 倍（14.6-23.8），死亡的可能性是间日疟原虫疟疾患者的≥14 倍（5.1-38.7）。
在该地区，恶性疟原虫和间日疟原虫感染都是住院的重要原因，但危及生命的间日疟原虫病很少见。
