Ajayi-Obe E K, Lodi E, Alkali A S, Galbati M, Rooney C, Mannoni B, Grim P, Nasidi A, Mohammed I
National Task Force on the Meningococcal Epidemic, Federal Ministry of Health, Nigeria.
Bull World Health Organ. 1998;76(2):149-52.
Current WHO guidelines for the case management of meningococcal infections during epidemics in developing countries often cannot be applied, largely because of the limited health resources in such countries. Several scoring scales based on clinical and laboratory features in numerous combinations have been developed for the management of meningococcal infections in developed countries, and these have facilitated early identification of patients with fulminant disease and thus early intervention and reduction in mortality. Unfortunately such scoring scales are not appropriate for use in developing countries. We identified hypotension, tachycardia, tachypnoea, delay in capillary refill time, coma, absence of neck stiffness and petechiae and/or purpura as simple prognostic factors of meningococcal disease. Two scores were developed: score I, which includes all seven prognostic factors, had a sensitivity and specificity of 80% and 94%, respectively. Score II, which excluded hypotension, had a sensitivity and specificity of 73.3% and 89.7%, respectively. Quick and simple scoring scales are therefore not only applicable but useful for the case management of patients in meningococcal epidemics in developing countries.
世界卫生组织目前针对发展中国家流行性脑脊髓膜炎感染病例管理的指南往往无法适用，主要原因是这些国家卫生资源有限。在发达国家，已开发出多种基于临床和实验室特征以不同组合方式的评分量表用于管理脑膜炎球菌感染，这些量表有助于早期识别暴发性疾病患者，从而实现早期干预并降低死亡率。遗憾的是，此类评分量表不适用于发展中国家。我们确定低血压、心动过速、呼吸急促、毛细血管再充盈时间延迟、昏迷、无颈部强直以及瘀点和/或紫癜为脑膜炎球菌病的简单预后因素。开发了两个评分：评分I包含所有七个预后因素，其敏感性和特异性分别为80%和94%。评分II排除了低血压，其敏感性和特异性分别为73.3%和89.7%。因此，快速且简单的评分量表不仅适用于发展中国家脑膜炎球菌流行期间患者的病例管理，而且很有用。
