O'Dempsey T J, McArdle T F, Laurence B E, Lamont A C, Todd J E, Greenwood B M
Medical Research Council Laboratories, Banjul, The Gambia.
Trans R Soc Trop Med Hyg. 1993 Nov-Dec;87(6):662-5. doi: 10.1016/0035-9203(93)90279-y.
Pneumonia and malaria are common causes of childhood morbidity and mortality in many developing countries and simple guidelines have been proposed to facilitate their diagnosis by relatively unskilled health workers. We have studied children in The Gambia attending out-patient and under-five clinics with clinically suspected pneumonia (cough or difficulty in breathing and a raised respiratory rate) during periods of high or low malaria transmission. During a period of high malaria transmission, 33% of these children had radiological evidence of pneumonia (with or without malaria parasitaemia) compared to 38% who had malaria parasitaemia, no radiological evidence of pneumonia and no other obvious cause of fever. Corresponding figures during a period of low malaria transmission were 48% and 6% respectively. The clinical overlap between pneumonia and malaria has important implications for case management strategies and evaluation of disease-specific interventions in regions in which both pneumonia and malaria are prevalent.
在许多发展中国家，肺炎和疟疾是儿童发病和死亡的常见原因，有人提出了简单的指导方针，以便技术相对不熟练的卫生工作者进行诊断。我们对冈比亚门诊和五岁以下诊所中在疟疾传播高峰期或低谷期临床疑似肺炎（咳嗽或呼吸困难且呼吸频率加快）的儿童进行了研究。在疟疾传播高峰期，这些儿童中有33%有肺炎的影像学证据（无论有无疟原虫血症），相比之下，有疟原虫血症、无肺炎影像学证据且无其他明显发热原因的儿童占38%。在疟疾传播低谷期，相应的数字分别为48%和6%。肺炎和疟疾在临床上的重叠对病例管理策略以及在肺炎和疟疾都流行的地区评估针对特定疾病的干预措施具有重要意义。
