Establishment and evaluation of different fever related syndromes for screening malaria patients

Dongshan Zhu, J. Gou, Jun Ge
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Abstract

Abstract Objective: Analyze the clinical symptoms of feverish population and select significant symptoms to establish fever related syndromes to screen malaria patients. Method: A“Registration form for patients with fever”was designed to gather information about symptoms of feverish population and standard blood smear was made for each patient to do the microscope test. SPSS 17.0 was used to analyze the distribution of clinical symptoms between malaria patients and non-malaria patients. Then the significant symptoms were selected to establish different syndromes by manual combined method. Sensitivity, positive predictive value (PPV), likelihood ratio, Youden index and Kappa were used for selecting the optimal syndrome. Result: 1508 forms were got and 241 of them were malaria patients. 12 symptoms had different distribution between malaria population and non-malaria population. 52 fever related syndromes were established by using the 12 symptoms. Finally, No.52 syndrome(body temperature above 39℃, periodic onset of fever and no diarrhea) were selected as the optimal syndrome, its sensitivity and positive predictive value were 74.3% and 84.4%. Conclusion: The optimal malaria related syndromes can be used as a screen tool to screen malaria patients, especially in the villages where equipment and professional staff were lack.
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疟疾患者筛查中不同发热相关综合征的建立与评价
摘要目的:分析发热人群的临床症状,选择显著症状建立发热相关综合征,筛查疟疾患者。方法:设计《发热患者登记表》,收集发热人群的症状信息,对发热人群进行标准血涂片镜检。采用SPSS 17.0统计软件分析疟疾患者与非疟疾患者临床症状分布。然后选取显著证候,采用手工组合法建立不同的证候。采用敏感性、阳性预测值(positive predictive value, PPV)、似然比、约登指数(Youden index)和Kappa等方法筛选最佳综合征。结果:共收到表格1508份,其中疟疾患者241份。12种症状在疟疾人群和非疟疾人群中分布不同。根据12种症状建立52种发热相关综合征。最终选择52号证候(体温39℃以上,周期性发热,无腹泻)为最佳证候,其敏感性为74.3%,阳性预测值为84.4%。结论:最佳疟疾相关证候可作为筛查疟疾患者的一种工具,特别是在设备和专业人员缺乏的村庄。
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