埃塞俄比亚西北部贡德尔大学医院重症疟疾患者的治疗结果及相关因素：一项回顾性研究（2020 - 2023年）

Treatment outcomes and associated factors in severe malaria patients at University of Gondar Hospital, Northwest Ethiopia: A retrospective study (2020-2023).

作者信息

Anteneh Marshet, Asres Mezgebu Silamsaw, Legese Geberehiwot Lema, Alemayehu Meron Asmamaw, Woldesenbet Dagmawi, Ayalew Desalew Getahun

机构信息

Bahir-Dar Blood Bank, Amhara National Regional State Health Bureau, Bahir-Dar, Ethiopia.

Department of Internal Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

PLoS One. 2024 Dec 3;19(12):e0309681. doi: 10.1371/journal.pone.0309681. eCollection 2024.

DOI:10.1371/journal.pone.0309681

PMID:39625962

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11614224/

Abstract

BACKGROUND

Malaria continues to be the most prevalent life-threatening parasitic illness in Ethiopia. Its clinical spectrum ranges from mild to severe, with a propensity for death. In Ethiopia, it accounts for 10% of hospital admission. Identifying predictors of malaria-related mortality is crucial for aiding high-risk patient identification and enabling timely intervention.

OBJECTIVE

Our study aimed to assess treatment outcomes and factors associated with mortality among severe malaria patients at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

METHODS

A retrospective cross-sectional study examined 383 randomly chosen patients with severe malaria, spanning a four-year period leading up to the data collection date, encompassing July 2023 back to June 2020. Data were collected from the hospital records. A structured questionnaire was used to collect the data. EpiData version 3.1 and SPSS version 20 were used to clean and analyze the data, respectively. Logistic regression analysis was conducted to determine associations and reported by the odds ratio at p < 0.05 with 95% confidence intervals.

RESULTS

Among the 383 eligible patients, the majorities were males (56.66%) and resided in rural areas (66.32%). Over 84% of them were referred from health facilities. Plasmodium falciparum was the major parasite identified in 78% of cases. The magnitude of death among severe malaria patients was 10.97%. Impaired consciousness, convulsions, jaundice, parasitemia level >2, and creatinine level ≥3 were significantly associated with death, with adjusted odds ratios (AOR) of 3.4 (95% CI: 1.3-8.3), 2.7 (95% CI: 1.004-7.492), 3.2 (95% CI: 1.173-9.182), 3.7 (95% CI: 1.516-9.113), and 11.7 (95% CI: 4.756-29.239), respectively.

CONCLUSION

Our study revealed a significant number of malaria-related deaths, with predictors such as age, impaired consciousness, convulsions, jaundice, parasitemia level, and creatinine level identified. Hence, it is imperative to implement intense and timely interventions for patients exhibiting these clinical manifestations to prevent malaria-related fatalities.

摘要

背景

疟疾仍然是埃塞俄比亚最普遍的危及生命的寄生虫病。其临床症状从轻度到重度不等，有死亡倾向。在埃塞俄比亚，它占医院入院人数的10%。确定疟疾相关死亡率的预测因素对于帮助识别高危患者和及时进行干预至关重要。

目的

我们的研究旨在评估埃塞俄比亚西北部贡德尔大学综合专科医院严重疟疾患者的治疗结果及与死亡率相关的因素。

方法

一项回顾性横断面研究检查了383例随机选择的严重疟疾患者，时间跨度为截至数据收集日期的四年，即从2023年7月追溯到2020年6月。数据从医院记录中收集。使用结构化问卷收集数据。分别使用EpiData 3.1版和SPSS 20版对数据进行清理和分析。进行逻辑回归分析以确定关联，并以p<0.05时的优势比及95%置信区间报告。

结果

在383例符合条件的患者中，大多数为男性（56.66%），居住在农村地区（66.32%）。超过84%的患者是从医疗机构转诊而来。恶性疟原虫是78%病例中鉴定出的主要寄生虫。严重疟疾患者的死亡率为10.97%。意识障碍、抽搐、黄疸、疟原虫血症水平>2以及肌酐水平≥3与死亡显著相关，调整后的优势比（AOR）分别为3.4（95%CI：1.3 - 8.3）、2.7（95%CI：1.004 - 7.492）、3.2（95%CI：1.173 - 9.182）、3.7（95%CI：1.516 - 9.113）和11.7（95%CI：4.756 - 29.239）。