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2023年刚果民主共和国卡塔科-孔贝疑似人类猴痘病例的临床特征:挑战与关键应对措施

Clinical characteristics of suspected cases of human mpox (monkeypox) in Katako-Kombe, Democratic Republic of the Congo 2023: challenges and key responses.

作者信息

Mbelambela Etongola Papy Steve, Wandja Akemo Jean Paul, Villanueva Antonio Fredelindo, Olamba Ndjongandeke Daniel, Omba Lohohola, Muchanga Sifa Marie Joelle

机构信息

Department of Environmental Medicine, Faculty of Medicine, Kochi University Kochi Medical School, Nankoku City, Japan.

Department of Public Health, Faculty of Medicine, Notre Dame University of Tshumbe, Sankuru, Democratic Republic of the Congo.

出版信息

Eur J Clin Microbiol Infect Dis. 2025 Mar;44(3):609-617. doi: 10.1007/s10096-024-05022-3. Epub 2024 Dec 21.

Abstract

OBJECTIVES

This study aimed to describe the clinical and epidemiologic characteristics of suspected cases of human mpox in one of the most affected health zones, Katako-Kombe, Sankuru Province, in the Democratic Republic of the Congo. Also, to identify key challenges to prevent and improve the health of the affected community.

METHODS

Between January 26, 2023 and November 30, 2023, the DRC reported its highest incidence of mpox cases,with a total of 12,569 suspected cases in 156 health zones from 22 of the 26 country's provinces. The Katako-Kombe Health Zone registered 369 suspected cases and 17 deaths, making it one of the hotspots of the outbreak.

RESULTS

Ten villages and centres were affected, with an attack rate (AT) of 2.15‰ and a case fatality rate (CFR) of 4.6%. Epi-curves showed an increase in clinical cases from January to May 2023, followed by a decrease until August 2023 and a resurgence of cases in September 2023, with a reproduction rate of 1.29. Furthermore, the occurrence of complications appeared to increase the CFR with 7 (14%), 11 (18.03%), and 9 (23.68%) for encephalitis, anemia, and pulmonary complications, respectively.

CONCLUSIONS

AT, CFR, and transmission rate appeared to be lower in the current epidemic than in previous outbreaks and in Clade I. Critically, delayed medical care increases the incidence of complications and CFR. Therefore, mpox requires early diagnosis and prompt public health response. Including the possibility of mpox in the differential diagnosis of patients presenting with a vesicular or pustular rash is suggested.

摘要

目的

本研究旨在描述刚果民主共和国桑库鲁省卡塔科 - 孔贝这个受灾最严重的卫生区之一的人类猴痘疑似病例的临床和流行病学特征。此外,还旨在确定预防和改善受影响社区健康的关键挑战。

方法

2023年1月26日至2023年11月30日期间,刚果民主共和国报告了猴痘病例的最高发病率,该国26个省中的22个省的156个卫生区共有12569例疑似病例。卡塔科 - 孔贝卫生区记录了369例疑似病例和17例死亡,使其成为疫情热点地区之一。

结果

10个村庄和中心受到影响,攻击率(AT)为2.15‰,病死率(CFR)为4.6%。流行曲线显示,2023年1月至5月临床病例增加,随后下降至2023年8月,2023年9月病例再次出现,传播率为1.29。此外,并发症的发生似乎增加了病死率,脑炎、贫血和肺部并发症的病死率分别为7例(14%)、11例(18.03%)和9例(23.68%)。

结论

在当前疫情中,攻击率、病死率和传播率似乎低于以往疫情以及分支I中的情况。至关重要的是,医疗护理延迟会增加并发症的发生率和病死率。因此,猴痘需要早期诊断和及时的公共卫生应对措施。建议在出现水疱或脓疱性皮疹的患者鉴别诊断中考虑猴痘的可能性。

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