尼日尔津德尔白喉疫情的再度出现。

The resurgence of diphtheria in Zinder, Niger.

作者信息

Mahamadou Doutchi, Bara Abdoul-Aziz Adamou, Mahaman Moustapha Lamine, Hassane Diongolé, Adoum Fils Souleymane, Hamsatou Bagnou, Thomas Abraham George, Sahada Moussa, Idrissa Hamadou, Ousmane Sani, Zaratou Ali, Abdoul Aziz Garba, Abdoulaye Ousmane, Eric Adehossi, Paul Eholié Serge

机构信息

Faculty of Medical Science André Salifou University, Zinder, Niger; Zinder National Hospital, Niger.

Faculty of Medical Science André Salifou University, Zinder, Niger.

出版信息

Infect Dis Now. 2024 Dec;54(8):104979. doi: 10.1016/j.idnow.2024.104979. Epub 2024 Sep 21.

DOI:10.1016/j.idnow.2024.104979

PMID:39313157

Abstract

BACKGROUND

Diphtheria is a re-emerging bacterial disease in developing countries with low vaccination coverage.

OBJECTIVES

This is a descriptive cross-sectional study of diphtheria cases reported to the DRSP/Zinder from March 14, 2022 through June 26, 2023.

METHODS

It includes cases reported through epidemiological surveillance and data on patients hospitalized in the infectious and tropical diseases department of the Zinder National Hospital (SMIT).

RESULTS

A total of 32 patients were included in this study. The median age was 12 years [4-22 years]. Key symptoms included dysphagia and odynophagia (100 %), false membranes (84.4 %), fever (46.9 %), thrombocytopenia (39.3 %), cervical lymphadenopathy (37 %), respiratory distress (15.6 %), epistaxis (12.5 %), gingival bleeding (9.4 %), agitation (6.2 %) and paresis (3.1 %). Renal function was altered in 74 % of cases. Diagnostic confirmation was procured through culture on oropharyngeal swabs. Corynebacterium diphtheriae was isolated in 26.31 % (5/19) of cases. Patients were treated with macrolides and diphtheria antitoxin. The case fatality rate was 31.2 %. Poor prognostic factors included gingival bleeding (p = 0.0262), respiratory distress (p = 0.0374), and thrombocytopenia below 50,000 platelets/mm (p = 0.0020).

CONCLUSION

Diphtheria is a deadly re-emerging disease. The fight against this condition necessitates improved vaccination coverage.

摘要

背景

白喉是一种在疫苗接种覆盖率低的发展中国家再度出现的细菌性疾病。

目的

这是一项描述性横断面研究，研究对象为2022年3月14日至2023年6月26日向尼亚美地区卫生信息系统/津德尔报告的白喉病例。

方法

研究包括通过流行病学监测报告的病例以及津德尔国家医院（SMIT）感染与热带病科住院患者的数据。

结果

本研究共纳入32例患者。中位年龄为12岁[4 - 22岁]。主要症状包括吞咽困难和吞咽痛（100%）、假膜（84.4%）、发热（46.9%）、血小板减少（39.3%）、颈部淋巴结肿大（37%）、呼吸窘迫（15.6%）、鼻出血（12.5%）、牙龈出血（9.4%）、烦躁不安（6.2%）和轻瘫（3.1%）。74%的病例出现肾功能改变。通过咽拭子培养进行诊断确认。26.31%（5/19）的病例分离出白喉棒状杆菌。患者接受了大环内酯类药物和白喉抗毒素治疗。病死率为31.2%。不良预后因素包括牙龈出血（p = 0.0262）、呼吸窘迫（p = 0.0374）和血小板计数低于50,000/mm³的血小板减少（p = 0.0020）。