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印度果阿邦首次基山努里森林病疫情期间受感染者的临床表现和危险因素研究:混合方法研究。

Study of the clinical manifestations and risk factors in people affected during the first Kyasanur Forest Disease outbreak in Goa, India: A mixed method study.

机构信息

General Medicine, Goa Medical College, India.

Department of Community Medicine, Goa Medical College, India.

出版信息

J Vector Borne Dis. 2024 Jan 1;61(1):23-28. doi: 10.4103/0972-9062.383650. Epub 2024 Mar 23.

Abstract

BACKGROUND OBJECTIVES

Kyasanur Forest Disease (KFD) is a tick-borne, zoonotic viral hemorrhagic fever, previously known to be endemic to the state of Karnataka, India. The first outbreak of KFD in Goa state was reported in the Sattari taluka, in North Goa in 2015. This study aimed to investigate the outbreak and report the clinical manifestations and risk factors in people diagnosed with KFD.

METHODS

A mixed methods approach was used, which included a case series report and 19 in-depth interviews (IDIs) conducted with people diagnosed with KFD. The recorded IDIs were transcribed and translated and themes were coded for the analysis.

RESULTS

There were 73 suspected cases of which 30 were confirmed to have KFD using RT-PCR. There were four suspected deaths of which two were confirmed by RT-PCR. Most of the affected individuals were found to be dependent on the forest for their livelihood. Most of the people in the region were engaged in cashew plantations and had to travel to the forest to fetch firewood and cashew, hence were at a higher risk. They lived near the forest. The lack of hemorrhagic manifestation was noteworthy in the current outbreak.

INTERPRETATION CONCLUSION

The 'One Health' approach should be implemented to control KFD. Tick bite prevention measures coupled with vaccination of high-risk groups and intensive health education should be carried out, especially before the transmission season. There is a need to have high clinical suspicion for KFD in the region bearing in mind the non-hemorrhagic manifestation in this outbreak.

摘要

背景目的

基孔肯雅热(KFD)是一种蜱传、人畜共患的病毒性出血热,以前被认为是印度卡纳塔克邦的地方病。2015 年,在北果阿的萨塔里县首次报告了果阿邦的 KFD 爆发。本研究旨在调查此次疫情,并报告确诊为 KFD 的患者的临床表现和危险因素。

方法

采用混合方法,包括病例系列报告和对确诊为 KFD 的患者进行的 19 次深入访谈(IDIs)。记录的 IDIs 被转录和翻译,并对主题进行编码进行分析。

结果

有 73 例疑似病例,其中 30 例经 RT-PCR 确诊为 KFD。有 4 例疑似死亡,其中 2 例经 RT-PCR 确诊。大多数受影响的人依赖森林为生。该地区的大多数人从事腰果种植,不得不前往森林砍柴和腰果,因此风险较高。他们住在森林附近。此次疫情中出血表现的缺乏值得注意。

解释结论

应实施“同一健康”方法来控制 KFD。应采取防蜱叮咬措施,结合对高危人群进行疫苗接种和强化卫生教育,特别是在传播季节之前。鉴于此次疫情中无出血表现,应高度怀疑该地区存在 KFD。

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