Prasertbun Rapeepun, Mori Hirotake, Hadano Yoshiro, Mahittikorn Aongart, Maude Rapeephan R, Naito Toshio
Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.
Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Am J Trop Med Hyg. 2024 Nov 19;112(2):414-421. doi: 10.4269/ajtmh.24-0017. Print 2025 Feb 5.
Acute undifferentiated febrile illnesses (AUFIs) are short-duration infectious diseases with nonspecific symptoms. In Thailand, common AUFIs include dengue, malaria, leptospirosis, scrub typhus, and typhoid fever. This study aimed to determine the case numbers of AUFI etiologies in Thailand before coronavirus disease 2019 (COVID-19) (phase 1 from January 2018 to February 2020) and during the COVID-19 pandemic with preventive measures (phase 2 from March 2020 to April 2022), and the loosening of the preventive measures (phase 3 from May 2022 to December 2022). We used Thailand's national database from 2018 to 2022 to determine the case numbers of AUFIs and geographic heat maps to identify endemic areas in Thailand. The case numbers of malaria, dengue, leptospirosis, typhoid, and scrub typhus significantly decreased during phase 2 (preventive measures) (P = 0.02), and cases of malaria and leptospirosis increased during phase 3 (loosened preventive measures) (P = 0.01). In 2022, malaria and leptospirosis increased by 39% and 48%, respectively, compared with the previous year. Malaria increased in western Thailand along the border between Thailand and Myanmar, where malaria preventive measures were insufficient, whereas leptospirosis increased in northern Thailand. The epidemiology of acute febrile diseases changes significantly depending on the global epidemic of infectious diseases such as COVID-19 and the implementation of preventive measures, such as face masks, hand hygiene, social distancing, and stay-at-home and lockdown measures.
急性未分化发热性疾病（AUFIs）是一类具有非特异性症状的短期传染病。在泰国，常见的AUFIs包括登革热、疟疾、钩端螺旋体病、恙虫病和伤寒热。本研究旨在确定2019冠状病毒病（COVID-19）之前（2018年1月至2020年2月的第1阶段）、COVID-19大流行期间采取预防措施时（2020年3月至2022年4月的第2阶段）以及预防措施放松期间（2022年5月至2022年12月的第3阶段）泰国AUFIs病因的病例数。我们使用了泰国2018年至2022年的国家数据库来确定AUFIs的病例数，并通过地理热图来识别泰国的流行地区。疟疾、登革热、钩端螺旋体病、伤寒和恙虫病的病例数在第2阶段（预防措施）显著下降（P = 0.02），而疟疾和钩端螺旋体病的病例数在第3阶段（预防措施放松）有所增加（P = 0.01）。与上一年相比，2022年疟疾和钩端螺旋体病分别增加了39%和48%。泰国西部与缅甸接壤的边境地区疟疾增加，该地区疟疾预防措施不足，而泰国北部钩端螺旋体病增加。急性发热性疾病的流行病学根据COVID-19等全球传染病的流行情况以及口罩、手部卫生、社交距离、居家和封锁措施等预防措施的实施而发生显著变化。
