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[感染性腹泻的流行病学与病因学。以墨西哥为例]

[Epidemiology and etiology of infectious diarrheas. The case of Mexico].

作者信息

Valdespino-Gomez J L, García-Garcia M L, Del Rio-Zolezzi A, Giono-Cerezo S, Salcedo-Alvarez R A, Sepúlveda-Amor J

机构信息

Instituto Nacional de Diagnóstico y Referencia Epidemiológicos, Mexico.

出版信息

Rev Latinoam Microbiol. 1994 Oct-Dec;36(4):307-24.

PMID:7701141
Abstract

Gastrointestinal infections represent a health problem. It is estimated that 1647 million cases of diarrhea and 3.2 million deaths due to this cause occur among children less than five years of age per year. Those belonging to this age group have 15 times more risk of dying because of diarrhea. Cases of liquid acute diarrhea with blood represent 80% of cases, diarrhea with blood represent 10%. Most frequent causes of liquid diarrhea are enterotoxigenic Escherichia coli and rotaviruses and most frequent causes of bloody diarrhea are Shigella, E. coli (EHEC and EPEC). Campylobacter jejuni and Entamoeba histolytica. Annually 15,000 cases of typhoid fever are reported that continue being a public health problem. A negative correlation has been observed between the use of oral rehydration and infant mortality due to diarrhea. After prevention and control measures for cholera, a decrease in morbidity and mortality due to diarrhea has been observed. However, to reduce mortality due to this cause, it is necessary to treat the cases of acute dysentery and persistent diarrhea as well as to increase coverage of health care, to standardize the studies of etiology of diarrhea in Mexico, to establish surveillance centers for the study of diarrhea that give information on the distribution, frequency and trends of microbial agents and to achieve standardized microbiological and parasitological studies of etiology of diarrhea that support public health interventions as vaccination and selective administration of antibiotics.

摘要

胃肠道感染是一个健康问题。据估计,每年五岁以下儿童中因腹泻导致16.47亿例发病及320万例死亡。该年龄组儿童因腹泻死亡的风险高出15倍。伴有便血的急性水样腹泻病例占80%,便血腹泻病例占10%。水样腹泻最常见的病因是产肠毒素大肠杆菌和轮状病毒,便血腹泻最常见的病因是志贺菌、大肠杆菌(肠出血性大肠杆菌和肠致病性大肠杆菌)、空肠弯曲菌和溶组织内阿米巴。每年报告15000例伤寒热病例,这仍是一个公共卫生问题。已观察到口服补液的使用与腹泻导致的婴儿死亡率之间呈负相关。在采取霍乱预防和控制措施后,腹泻的发病率和死亡率有所下降。然而,为降低由此导致的死亡率,有必要治疗急性痢疾和持续性腹泻病例,提高医疗保健覆盖率,规范墨西哥腹泻病因学研究,建立腹泻研究监测中心以提供有关微生物病原体分布、频率和趋势的信息,并开展标准化的腹泻病因微生物学和寄生虫学研究,以支持诸如疫苗接种和抗生素选择性给药等公共卫生干预措施。

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