Pub Date : 2021-01-01DOI: 10.13604/J.CNKI.46-1064/R.2021.01.16
Z. Xuan, Ruan Wei, Wang Xiao-xiao, Chen Hualiang, Feng Yan, Yu KeGen, Zhang Jia-qi, Yao Linong
Objective To analyze diagnosis of imported malaria in Zhejiang Province duiring 2012-2019, to prevent transmission after elimination of malaria, we provide the foundation for malaria prevention and control. Methods Malaria case information, epidemiological investigation data on imported malaria cases in Zhejiang Province from 2012 to 2019 were collected through Parasitosis Prevention and Control Information System of China Disease Prevention and Control Information System (CISDCP). The diagnostic methods, diagnostic institutions and onset-diagnosis time of imported malaria cases were described and analyzed. Results A total of 1 543 malaria cases were reported in Zhejiang Province during 2012-2019, and all of which were imported. Majority of the cases were Plasmodium falciparum (71.2%). The utilization rate of RDT increased from 62.86% (88/140) in 2012 to 88.76% (158/178) in 2019. The rate of diagnosis in CDC decreased from 35.7% (50/140) in 2012 to 9.6% (17/178) in 2019 ( P <0.05), while that in medical institutions increased from 55% (77/140) in 2012 to 88.2% (157/178) in 2019. And the diagnosis rate of county-level medical institutions was statistically significant from 2012 to 2019 ( P <0.05). The median time from onset to initial diagnosis and from initial diagnosis to confirmation of malaria cases was 1 day, respectively. The time interval from initial diagnosis to confirmation was statistically different in each year ( P <0.001). The interval from initial diagnosis to confirmation of Plasmodium falciparum was shorter than that of other species ( P <0.001). The interval from onset to initial diagnosis of the institutions below county-level was shorter than that of the institutions at other levels ( P <0.001). Conclusions The diagnostic awareness and capabilities of medical institutions should be further strengthened, and health education should be strengthened to increase awareness of medical treatment, to prevent re-transmission of imported malaria after elimination. 摘要:目的 分析2012—2019年浙江省报告疟疾病例诊断情况,防止消除疟疾后再传播,为消除后疟疾工作的防 控策略和措施提供依据。 方法 收集中国疾病预防控制信息系统的寄生虫病防治信息系统中2012—2019年浙江省报 告的疟疾病例信息、流行病学调査等资料,对其诊断方式、诊断单位、诊断间隔时间等进行描述和统计学分析。 结果 2012—2019年浙江省共报告1 543例疟疾病例,全部为输人性病例,疟疾类型以恶性疟为主(71.2%)。RDT的使 用率从2012年的62.86%(88/140)升高到2019年的88.76%(158/178)。各年间疾控机构诊断比例从2012年的35.7% (50/140)下降至2019年的9.6% (17/178)( P <0.05),医疗机构诊断比例由2012年的55.0%(77/140)上升至2019年的 88.2%(157/178),各年间县级医疗机构诊断比例差异有统计学意义( P <0.05)。发病-初诊和初诊-确诊间隔天数的中位 数均为1 d,各年份初次就诊-确诊时间间隔差异有统计学意义( P <0.001)。恶性疟的初诊-确诊间隔时间短于其他虫种 ( P <0.001)县级以下单位较其他层级单位的发病-初诊时间短（ P <0.001)。 结论 消除后阶段需继续加强医务人员业 务知识培训,提高疟疾诊断水平和能力,提高群众就诊意识,防止输人性病例继发传播。
{"title":"Diagnosis of imported malaria cases in Zhejiang, 2012-2019","authors":"Z. Xuan, Ruan Wei, Wang Xiao-xiao, Chen Hualiang, Feng Yan, Yu KeGen, Zhang Jia-qi, Yao Linong","doi":"10.13604/J.CNKI.46-1064/R.2021.01.16","DOIUrl":"https://doi.org/10.13604/J.CNKI.46-1064/R.2021.01.16","url":null,"abstract":"Objective To analyze diagnosis of imported malaria in Zhejiang Province duiring 2012-2019, to prevent transmission after elimination of malaria, we provide the foundation for malaria prevention and control. Methods Malaria case information, epidemiological investigation data on imported malaria cases in Zhejiang Province from 2012 to 2019 were collected through Parasitosis Prevention and Control Information System of China Disease Prevention and Control Information System (CISDCP). The diagnostic methods, diagnostic institutions and onset-diagnosis time of imported malaria cases were described and analyzed. Results A total of 1 543 malaria cases were reported in Zhejiang Province during 2012-2019, and all of which were imported. Majority of the cases were Plasmodium falciparum (71.2%). The utilization rate of RDT increased from 62.86% (88/140) in 2012 to 88.76% (158/178) in 2019. The rate of diagnosis in CDC decreased from 35.7% (50/140) in 2012 to 9.6% (17/178) in 2019 ( P <0.05), while that in medical institutions increased from 55% (77/140) in 2012 to 88.2% (157/178) in 2019. And the diagnosis rate of county-level medical institutions was statistically significant from 2012 to 2019 ( P <0.05). The median time from onset to initial diagnosis and from initial diagnosis to confirmation of malaria cases was 1 day, respectively. The time interval from initial diagnosis to confirmation was statistically different in each year ( P <0.001). The interval from initial diagnosis to confirmation of Plasmodium falciparum was shorter than that of other species ( P <0.001). The interval from onset to initial diagnosis of the institutions below county-level was shorter than that of the institutions at other levels ( P <0.001). Conclusions The diagnostic awareness and capabilities of medical institutions should be further strengthened, and health education should be strengthened to increase awareness of medical treatment, to prevent re-transmission of imported malaria after elimination. 摘要:目的 分析2012—2019年浙江省报告疟疾病例诊断情况,防止消除疟疾后再传播,为消除后疟疾工作的防 控策略和措施提供依据。 方法 收集中国疾病预防控制信息系统的寄生虫病防治信息系统中2012—2019年浙江省报 告的疟疾病例信息、流行病学调査等资料,对其诊断方式、诊断单位、诊断间隔时间等进行描述和统计学分析。 结果 2012—2019年浙江省共报告1 543例疟疾病例,全部为输人性病例,疟疾类型以恶性疟为主(71.2%)。RDT的使 用率从2012年的62.86%(88/140)升高到2019年的88.76%(158/178)。各年间疾控机构诊断比例从2012年的35.7% (50/140)下降至2019年的9.6% (17/178)( P <0.05),医疗机构诊断比例由2012年的55.0%(77/140)上升至2019年的 88.2%(157/178),各年间县级医疗机构诊断比例差异有统计学意义( P <0.05)。发病-初诊和初诊-确诊间隔天数的中位 数均为1 d,各年份初次就诊-确诊时间间隔差异有统计学意义( P <0.001)。恶性疟的初诊-确诊间隔时间短于其他虫种 ( P <0.001)县级以下单位较其他层级单位的发病-初诊时间短（ P <0.001)。 结论 消除后阶段需继续加强医务人员业 务知识培训,提高疟疾诊断水平和能力,提高群众就诊意识,防止输人性病例继发传播。","PeriodicalId":10045,"journal":{"name":"中国热带医学","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89299767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.13604/J.CNKI.46-1064/R.2021.01.02
Feng Jun, Zhang Li, Tu Hong, Zhou Shui-sen, Xia Zhigui
Objective To analyze malaria epidemiological characteristics in China, 2010-2019, so as to provide evidence-based proof for target interventions on malaria elimination. Methods The data of web-based Infectious Disease Information Reporting Management System (IDIRMS) and Parasitic Diseases Information Reporting Management System (PDIRMS) from 2010 to 2019 were collected and analyzed. Results During 2010-2019, imported malaria cases were reported in all provinces, and in total 29 248 reported cases(2 925 cases annually), including 767 clinically diagnosed cases (2.62%), 7 388 Plasmodium vivax cases (25.26%), 18 032 P. falciparum cases (61.65%), 524 P. malariae cases (1.79%), 2 049 P. ovale cases (7.01%), 370 mixed-infection (1.27%), 2 P. knowlesi (0.01%), and 116 unclassified cases (0.40%). The imported malaria cases were mainly from Myanmar (2 750 cases, 9.40%), Ghana (2 606, 8.91%) and Nigeria (2 127, 7.27%); and most of them were reported in Yunnan (5 794, 19.81%), Guangxi (3 130, 10.70%) and Jiangsu (2 917, 9.97%). The temporal distribution was concentrated in June (4 141, 14.16%). Most cases (27 454, 93.87%) were found in male. A total of 181 deaths resulting from P. falciparum were reported. No obvious difference was found among interval from onset to diagnosis during the same timeframe ( P >0.05). From 2013 to 2019, the imported cases were mainly diagnosed (8 680, 39.75%) and reported (8 783, 40.22%) at county level. The proportion of diagnosis and report at county level exhibit an decreasing trend, while the municipal level was seen with a increasing trend. From 2013 to 2019, the imported cases were diagnosed (15 730, 72.03%) and reported (16 536, 75.72%) by medical institutions. The proportion of diagnosis and report by medical institutions exhibit an increasing trend, while the CDC institutions were observed with a decreasing trend. Conclusion To prevent the re-establishment caused by imported malaria, it is necessary to continue to strengthen inter-sectoral collaboration and surveillance, to carry out timely detection and appropriately treatment of imported cases, carefully investigate and assess the transmission risk of imported cases, and timely response to the risk foci or population. Furthermore, it is essential to conduct “strengthen inter-sectoral collaboration, timely case detection, promptly foci response” to effectively blocking the risk of re-establishment, and consolidating the achievements of malaria elimination. 摘要:目的 分析 2010—2019 年全国输人性疟疾疫情特征, 为各地消除疟疾后防止输人再传播工作提供依据。 方法 利用中国疾病预防控制中心疾病监测信息报告管理系统 (网络直报系统) 和寄生虫病监测信息报告管理系统 (寄生虫病专报系统), 收集 2010—2019 年全国输人性疟疾疫情数据资料, 建立数据库进行统计分析。 结果 2010—2019 年, 全国各省均有输人性疟疾病例分布, 共报告 29 248 例(年均 2 925 例), 其中临床诊断疟疾病例 767 例 (2.62%)、 间日疟 7 388 例 (25.26%)、恶性疟 18 032 例 (61.65%)、三日疟 524 例 (1.79%)、卵形疟 2 049 例 (7.01%)、诺氏疟 2 例 (0.01%)、混合感染 370 例 (1.27%) 和未分型病例 116 例 (0.40%)。病例主要输自缅甸 (2 750 例, 9.40%)、加纳 (2 606 例, 8.91%) 和尼日利亚 (2 127 例, 7.27%) 等国；主要分布在云南 (5 794 例, 19.81%)、广西 (3 130 例, 10.70%)和江苏 (2 917 例, 9.97%
{"title":"From elimination to post-elimination: Characteristics, challenges and re-transmission preventing strategy of imported malaria in China","authors":"Feng Jun, Zhang Li, Tu Hong, Zhou Shui-sen, Xia Zhigui","doi":"10.13604/J.CNKI.46-1064/R.2021.01.02","DOIUrl":"https://doi.org/10.13604/J.CNKI.46-1064/R.2021.01.02","url":null,"abstract":"Objective To analyze malaria epidemiological characteristics in China, 2010-2019, so as to provide evidence-based proof for target interventions on malaria elimination. Methods The data of web-based Infectious Disease Information Reporting Management System (IDIRMS) and Parasitic Diseases Information Reporting Management System (PDIRMS) from 2010 to 2019 were collected and analyzed. Results During 2010-2019, imported malaria cases were reported in all provinces, and in total 29 248 reported cases(2 925 cases annually), including 767 clinically diagnosed cases (2.62%), 7 388 Plasmodium vivax cases (25.26%), 18 032 P. falciparum cases (61.65%), 524 P. malariae cases (1.79%), 2 049 P. ovale cases (7.01%), 370 mixed-infection (1.27%), 2 P. knowlesi (0.01%), and 116 unclassified cases (0.40%). The imported malaria cases were mainly from Myanmar (2 750 cases, 9.40%), Ghana (2 606, 8.91%) and Nigeria (2 127, 7.27%); and most of them were reported in Yunnan (5 794, 19.81%), Guangxi (3 130, 10.70%) and Jiangsu (2 917, 9.97%). The temporal distribution was concentrated in June (4 141, 14.16%). Most cases (27 454, 93.87%) were found in male. A total of 181 deaths resulting from P. falciparum were reported. No obvious difference was found among interval from onset to diagnosis during the same timeframe ( P >0.05). From 2013 to 2019, the imported cases were mainly diagnosed (8 680, 39.75%) and reported (8 783, 40.22%) at county level. The proportion of diagnosis and report at county level exhibit an decreasing trend, while the municipal level was seen with a increasing trend. From 2013 to 2019, the imported cases were diagnosed (15 730, 72.03%) and reported (16 536, 75.72%) by medical institutions. The proportion of diagnosis and report by medical institutions exhibit an increasing trend, while the CDC institutions were observed with a decreasing trend. Conclusion To prevent the re-establishment caused by imported malaria, it is necessary to continue to strengthen inter-sectoral collaboration and surveillance, to carry out timely detection and appropriately treatment of imported cases, carefully investigate and assess the transmission risk of imported cases, and timely response to the risk foci or population. Furthermore, it is essential to conduct “strengthen inter-sectoral collaboration, timely case detection, promptly foci response” to effectively blocking the risk of re-establishment, and consolidating the achievements of malaria elimination. 摘要:目的 分析 2010—2019 年全国输人性疟疾疫情特征, 为各地消除疟疾后防止输人再传播工作提供依据。 方法 利用中国疾病预防控制中心疾病监测信息报告管理系统 (网络直报系统) 和寄生虫病监测信息报告管理系统 (寄生虫病专报系统), 收集 2010—2019 年全国输人性疟疾疫情数据资料, 建立数据库进行统计分析。 结果 2010—2019 年, 全国各省均有输人性疟疾病例分布, 共报告 29 248 例(年均 2 925 例), 其中临床诊断疟疾病例 767 例 (2.62%)、 间日疟 7 388 例 (25.26%)、恶性疟 18 032 例 (61.65%)、三日疟 524 例 (1.79%)、卵形疟 2 049 例 (7.01%)、诺氏疟 2 例 (0.01%)、混合感染 370 例 (1.27%) 和未分型病例 116 例 (0.40%)。病例主要输自缅甸 (2 750 例, 9.40%)、加纳 (2 606 例, 8.91%) 和尼日利亚 (2 127 例, 7.27%) 等国；主要分布在云南 (5 794 例, 19.81%)、广西 (3 130 例, 10.70%)和江苏 (2 917 例, 9.97%","PeriodicalId":10045,"journal":{"name":"中国热带医学","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89886504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.13604/j.cnki.46-1064/r.2021.06.04
Shizhen Li
Objective: To evaluate the prevalent epidemics of major respiratory viral infectious diseases in neighboring countries of the South China Sea such as Vietnam, Malaysia and Philippines from 2007 to 2019.
{"title":"A systematic review of prevalent epidemics of major respiratory viral infectious diseases in Vietnam, Malaysia and Philippines, 2007-2019","authors":"Shizhen Li","doi":"10.13604/j.cnki.46-1064/r.2021.06.04","DOIUrl":"https://doi.org/10.13604/j.cnki.46-1064/r.2021.06.04","url":null,"abstract":"Objective: To evaluate the prevalent epidemics of major respiratory viral infectious diseases in neighboring countries of the South China Sea such as Vietnam, Malaysia and Philippines from 2007 to 2019.","PeriodicalId":10045,"journal":{"name":"中国热带医学","volume":"63 1","pages":"517-525"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77243741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.13604/J.CNKI.46-1064/R.2021.01.23
Zhu Ming-chao, Zhu Ya
To discuss the clinical characteristics and epidemiological data of an imported malaria case with diarrhea as the first symptom, so as to provide reference for the diagnosis, treatment and prevention of imported malaria. The data of laboratory test results, clinical diagnosis and treatment experience and epidemiology, were collected and analyzed. Diarrhea was the first symptom of malaria in this patient. Blood cell analysis: White blood cell count (WBC) 5.02×10 9 /L, red blood cell count (RBC) 3.91×10 12 /L, hemoglobin (HGB) 130 g/L, platelet count (PLT) 81×10 9 /L, neutrophils (NEU%) 85.1%, the proportion of eosinophils (EOS%) 1.3%, C-reactive protein (CRP) 53.29 mg/L, the plasma D dimer 4.93 µg/mL, the parasite rapid diagnostic reagent (RDT) prompted Plasmodium falciparum , microscopic examination of the parasites showed annular body. Dihydroartemisinin-piperaquine tablets were administered orally immediately, and the symptoms were relieved 2 days later. The blood samples of the patients were identified by PCR typing as Plasmodium falciparum . Imported malaria has been reported from time to time in China, and entry-exit inspection and quarantine departments should strengthen health education of malaria prevention and treatment and the screening of malaria patients, and clinicians should enhance the awareness of national history diagnosis when receiving patients, so as to prevent the missed detection and misdiagnosis of malaria with diarrhea and other atypical symptoms as the first symptoms. 摘要: 探讨一例以腹泻为首发症状的输人性疟疾病例的临床特征和流行病学资料,为输人性疟疾诊治及预防提 供参考资料。收集该病例实验室检测结果、临床诊治经历及流行病学等资料并进行分析。该患者疟疾发作以腹泻为 首发症状,血细胞分析：白细胞计数(WBC)5.02×10 9 /L,红细胞计数(RBC)3.91×10 12 /L,血红蛋白（HGB)130g/L,血小板 计数(PLT)81×10 9 /L,中性粒细胞比例(NEU%)85.1%,嗜酸性粒细胞比例(EOS%) 1.3%。C-反应蛋白(CRP)53.29 mg/L,血浆D 二聚体4.93 µg/mL。疟原虫快速诊断试剂(RDT)检测提示恶性疟原虫,显微镜检出疟原虫环状体。立即行双氢 青蒿素哌喹片口服药物治疗,2 d后症状缓解,患者血样经PCR分型鉴定为恶性疟原虫。我国输人性疟疾报道时有发 生,出人境检验检疫部门应加强疟疾防治健康教育和疟疾病人排査力度,临床医生在接诊患者时应提高出国史问诊意 识,防止这种以腹泻等不典型为首发症状的疟疾漏检和误诊。
{"title":"A case report of imported falciparum malaria infection with diarrhea as the first symptom","authors":"Zhu Ming-chao, Zhu Ya","doi":"10.13604/J.CNKI.46-1064/R.2021.01.23","DOIUrl":"https://doi.org/10.13604/J.CNKI.46-1064/R.2021.01.23","url":null,"abstract":"To discuss the clinical characteristics and epidemiological data of an imported malaria case with diarrhea as the first symptom, so as to provide reference for the diagnosis, treatment and prevention of imported malaria. The data of laboratory test results, clinical diagnosis and treatment experience and epidemiology, were collected and analyzed. Diarrhea was the first symptom of malaria in this patient. Blood cell analysis: White blood cell count (WBC) 5.02×10 9 /L, red blood cell count (RBC) 3.91×10 12 /L, hemoglobin (HGB) 130 g/L, platelet count (PLT) 81×10 9 /L, neutrophils (NEU%) 85.1%, the proportion of eosinophils (EOS%) 1.3%, C-reactive protein (CRP) 53.29 mg/L, the plasma D dimer 4.93 µg/mL, the parasite rapid diagnostic reagent (RDT) prompted Plasmodium falciparum , microscopic examination of the parasites showed annular body. Dihydroartemisinin-piperaquine tablets were administered orally immediately, and the symptoms were relieved 2 days later. The blood samples of the patients were identified by PCR typing as Plasmodium falciparum . Imported malaria has been reported from time to time in China, and entry-exit inspection and quarantine departments should strengthen health education of malaria prevention and treatment and the screening of malaria patients, and clinicians should enhance the awareness of national history diagnosis when receiving patients, so as to prevent the missed detection and misdiagnosis of malaria with diarrhea and other atypical symptoms as the first symptoms. 摘要: 探讨一例以腹泻为首发症状的输人性疟疾病例的临床特征和流行病学资料,为输人性疟疾诊治及预防提 供参考资料。收集该病例实验室检测结果、临床诊治经历及流行病学等资料并进行分析。该患者疟疾发作以腹泻为 首发症状,血细胞分析：白细胞计数(WBC)5.02×10 9 /L,红细胞计数(RBC)3.91×10 12 /L,血红蛋白（HGB)130g/L,血小板 计数(PLT)81×10 9 /L,中性粒细胞比例(NEU%)85.1%,嗜酸性粒细胞比例(EOS%) 1.3%。C-反应蛋白(CRP)53.29 mg/L,血浆D 二聚体4.93 µg/mL。疟原虫快速诊断试剂(RDT)检测提示恶性疟原虫,显微镜检出疟原虫环状体。立即行双氢 青蒿素哌喹片口服药物治疗,2 d后症状缓解,患者血样经PCR分型鉴定为恶性疟原虫。我国输人性疟疾报道时有发 生,出人境检验检疫部门应加强疟疾防治健康教育和疟疾病人排査力度,临床医生在接诊患者时应提高出国史问诊意 识,防止这种以腹泻等不典型为首发症状的疟疾漏检和误诊。","PeriodicalId":10045,"journal":{"name":"中国热带医学","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89459140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.13604/J.CNKI.46-1064/R.2021.01.13
Z. Min, Wu Huan-yu, Zhang Chen-gang, Z. Yao-guang, W. Zhen-yu, Ma Xiao-Jiang
Objective To understand epidemiological characteristics of malaria cases reported in Shanghai, so as to provide scientific evidence for better prevention and control of malaria. Methods The data of malaria reported in Shanghai during 2016-2019 were collected from the Information Management System for Infection Disease Report and Information Management System for Parasitic Disease Control and Prevention, and the clinical manifestation, diagnosis and treatment were collected and statistically analyzed by SPSS22.0. Results Totally 183 malaria cases were reported in Shanghai during 2016–2019, all of them were laboratory confirmed cases, including 139 P.falciparum cases (76.0%), 23 P.ovale cases (12.6%), 11 P. vivax cases (6.0%), and 10 P. malariae cases (5.5%). All the cases were imported from Africa ( n =178, 97.3%) and southeast Asian ( n =5, 2.73%). Most of the cases fell into the age range of 30-<40 years ( n =59, 32.2%) with a male-to-female ratio of 10.4:1. There were significant differences ( P <0.01) in the rate of misdiagnosis and the rate of over 3 days diagnosis between severe malaria (51.6%, 16/31; 38.7%, 12/31) and non-severe malaria (27.0%, 41/152; 13.8%, 21/152). One severe malaria case was finally dead. Conclusions Imported cases were still existed in Shanghai after malaria elimination. Misdiagnosis and delayed diagnosis were the main factors for the occurrence of severe malaria. It is suggested to carry out health education, active screening and skill training of diagnosis and treatment to achieve "early detection, early diagnosis and early treatment", so as to avoid the occurrence of malaria deaths. 摘要:目的 了解上海市疟疾消除后的流行病学特征, 为制订输人性疟疾的防控策略和措施提供依据。 方法 收集 2016—2019 年上海市疟疾疫情信息和疟疾病例个案调査资料, 采用SPSS22.0统计软件对疟疾病例的流行特征与感 染诊治情况进行统计分析。 结果 2016—2019 年上海市共报告疟疾183例, 均为实验室确诊病例, 其中恶性疟139 例 (占 76.0%), 卵形疟 23 例 (占 12.6%), 间日疟11例 (占6.0%), 三日疟 10 例 (占 5.5%)。所有病例均为境外输人, 分别来 自非洲 (178 例, 占 97.3%)和东南亚(5例, 占 2.7%)。病例的男女性别比为 10.4:1, 年龄 30~<40 岁 (59 例, 占 32.2%)。重 症疟疾的初诊误诊比例 51.6% (16/31) 和超过 3d 确诊比例 38.7% (12/31) 与非重症疟疾的 27.0% (41/152)、13.8% (21/152) 的差异均有统计学意义 ( P <0.01), 1 例重症病例导致死亡。 结论 疟疾消除以后上海市仍然面临境外输人的风 险, 首诊误诊和确诊时间延迟是重症疟疾发生的主要影响因素。建议有针对性地开展风险人群健康宣教、主动筛査以 及诊疗技能培训, 做到“早发现、早诊断、早治疗”, 避免疟疾死亡病例的发生。
{"title":"Epidemiological analysis of imported malaria reported in Shanghai, 2016-2019","authors":"Z. Min, Wu Huan-yu, Zhang Chen-gang, Z. Yao-guang, W. Zhen-yu, Ma Xiao-Jiang","doi":"10.13604/J.CNKI.46-1064/R.2021.01.13","DOIUrl":"https://doi.org/10.13604/J.CNKI.46-1064/R.2021.01.13","url":null,"abstract":"Objective To understand epidemiological characteristics of malaria cases reported in Shanghai, so as to provide scientific evidence for better prevention and control of malaria. Methods The data of malaria reported in Shanghai during 2016-2019 were collected from the Information Management System for Infection Disease Report and Information Management System for Parasitic Disease Control and Prevention, and the clinical manifestation, diagnosis and treatment were collected and statistically analyzed by SPSS22.0. Results Totally 183 malaria cases were reported in Shanghai during 2016–2019, all of them were laboratory confirmed cases, including 139 P.falciparum cases (76.0%), 23 P.ovale cases (12.6%), 11 P. vivax cases (6.0%), and 10 P. malariae cases (5.5%). All the cases were imported from Africa ( n =178, 97.3%) and southeast Asian ( n =5, 2.73%). Most of the cases fell into the age range of 30-<40 years ( n =59, 32.2%) with a male-to-female ratio of 10.4:1. There were significant differences ( P <0.01) in the rate of misdiagnosis and the rate of over 3 days diagnosis between severe malaria (51.6%, 16/31; 38.7%, 12/31) and non-severe malaria (27.0%, 41/152; 13.8%, 21/152). One severe malaria case was finally dead. Conclusions Imported cases were still existed in Shanghai after malaria elimination. Misdiagnosis and delayed diagnosis were the main factors for the occurrence of severe malaria. It is suggested to carry out health education, active screening and skill training of diagnosis and treatment to achieve \"early detection, early diagnosis and early treatment\", so as to avoid the occurrence of malaria deaths. 摘要:目的 了解上海市疟疾消除后的流行病学特征, 为制订输人性疟疾的防控策略和措施提供依据。 方法 收集 2016—2019 年上海市疟疾疫情信息和疟疾病例个案调査资料, 采用SPSS22.0统计软件对疟疾病例的流行特征与感 染诊治情况进行统计分析。 结果 2016—2019 年上海市共报告疟疾183例, 均为实验室确诊病例, 其中恶性疟139 例 (占 76.0%), 卵形疟 23 例 (占 12.6%), 间日疟11例 (占6.0%), 三日疟 10 例 (占 5.5%)。所有病例均为境外输人, 分别来 自非洲 (178 例, 占 97.3%)和东南亚(5例, 占 2.7%)。病例的男女性别比为 10.4:1, 年龄 30~<40 岁 (59 例, 占 32.2%)。重 症疟疾的初诊误诊比例 51.6% (16/31) 和超过 3d 确诊比例 38.7% (12/31) 与非重症疟疾的 27.0% (41/152)、13.8% (21/152) 的差异均有统计学意义 ( P <0.01), 1 例重症病例导致死亡。 结论 疟疾消除以后上海市仍然面临境外输人的风 险, 首诊误诊和确诊时间延迟是重症疟疾发生的主要影响因素。建议有针对性地开展风险人群健康宣教、主动筛査以 及诊疗技能培训, 做到“早发现、早诊断、早治疗”, 避免疟疾死亡病例的发生。","PeriodicalId":10045,"journal":{"name":"中国热带医学","volume":"28 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77553404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.13604/J.CNKI.46-1064/R.2021.01.21
Luan He, WU Ze-zhou, Liao Bo-ming
Objective To analyze the clinical characteristics, results of laboratory examination and treatment strategies of patients with imported malaria, to provide experience for malaria prevention, control, diagnosis and treatment. Methods Collected clinical data of 39 imported malaria patients admitted to the First Affiliated Hospital of Guangxi Medical University from July 2012 to December 2019, the patient’s general condition, clinical manifestations, laboratory examinations, diagnosis and treatment were retrospectively analyzed. Results The 39 patients included 37 males and 2 females. Their average age was (38.79±9.74) years old. There were 20 cases with falciparum malaria, 3 cases with vivax malaria, 2 cases with mixed infection by falciparum malaria and vivax malaria, 1 case with malaria ovale, 1 case with malariae infection, and 12 cases with unknown type. All patients had fever symptoms. The common symptoms included fatigue (74.36%), headache (33.33%), splenomegaly (30.77%), nausea and vomiting (28.21%), et al. Complications occurred in 17 patients. After treatment, the patient’s hemoglobin level [(99.94±23.06) g/L] was lower than before treatment [(116.97 ±28.30) g/L], the difference was statistically significant ( t =2.6561, P <0.05), and platelets increased in after treatment [(209.24 ± 100.31)×10 9 /L] compared to before treatment [(102.12 ± 86.98)×10 9 /L], the difference was statistically significant ( t =–4.6801, P <0.001). Thirty-eight patients were treated with artesunate-based treatment. Except for one death, the rest were cured and discharged. Conclusion Falciparum malaria is the main infectious species in imported malaria cases, which has many complications. Early identification and diagnosis of malaria is the key to treatment. The phenomenon of increased platelets and decreased hemoglobin after treatment of imported malaria is of significant significance and is worthy of further study. 摘要:目的 分析输人性疟疾患者的临床特征,实验室检査结果及治疗策略,为疟疾防控及诊治提供经验。 方法 收集2012年7月至2019年12月广西医科大学第一附属医院收治的39例输人性疟疾患者的临床资料,对患者的 一般情况、临床表现、实验室检査 、 诊断治疗情况等进行回顾性分析。 结果 39例患者中男性37例,女性2例,平均年 龄(38.79±9.74)岁。其中,恶性疟20例,间日疟3例,恶性疟混合间日疟2例,卵形疟1例,三日疟1例,分型不详12例。所有患者均有发热症状,乏力（占74.36%)、头痛（占33.33%)、脾大（占30.77%)、恶心呕吐（占28.21%)等为常见临床症 状,17例患者出现相关并发症。患者经治疗后血红蛋白水平[(99.94±23.06)g/L]较治疗前[(116.97±28.30)g/L]降低,差异 有统计学意义 t =2.6561, P <0.05),血小板[(209.24±100.31)×10 9 /L]较治疗前[(102.12±86.98)×10 9 /L]升高,差异有统计学 意义( t =-4.6801, P <0.001)。38例患者选用以青蒿琥酯为基础的治疗,除1例恶性疟重症患者死亡外,其余患者治愈出 院。 结论 输人性疟疾感染虫种主要是恶性疟原虫,常合并多种并发症,尽早识别及诊断疟疾是治疗的关键。其治疗 后出现血小板升高和血红蛋白降低具有显著意义,值得进一步研究。
{"title":"Clinical analysis of 39 imported malaria cases","authors":"Luan He, WU Ze-zhou, Liao Bo-ming","doi":"10.13604/J.CNKI.46-1064/R.2021.01.21","DOIUrl":"https://doi.org/10.13604/J.CNKI.46-1064/R.2021.01.21","url":null,"abstract":"Objective To analyze the clinical characteristics, results of laboratory examination and treatment strategies of patients with imported malaria, to provide experience for malaria prevention, control, diagnosis and treatment. Methods Collected clinical data of 39 imported malaria patients admitted to the First Affiliated Hospital of Guangxi Medical University from July 2012 to December 2019, the patient’s general condition, clinical manifestations, laboratory examinations, diagnosis and treatment were retrospectively analyzed. Results The 39 patients included 37 males and 2 females. Their average age was (38.79±9.74) years old. There were 20 cases with falciparum malaria, 3 cases with vivax malaria, 2 cases with mixed infection by falciparum malaria and vivax malaria, 1 case with malaria ovale, 1 case with malariae infection, and 12 cases with unknown type. All patients had fever symptoms. The common symptoms included fatigue (74.36%), headache (33.33%), splenomegaly (30.77%), nausea and vomiting (28.21%), et al. Complications occurred in 17 patients. After treatment, the patient’s hemoglobin level [(99.94±23.06) g/L] was lower than before treatment [(116.97 ±28.30) g/L], the difference was statistically significant ( t =2.6561, P <0.05), and platelets increased in after treatment [(209.24 ± 100.31)×10 9 /L] compared to before treatment [(102.12 ± 86.98)×10 9 /L], the difference was statistically significant ( t =–4.6801, P <0.001). Thirty-eight patients were treated with artesunate-based treatment. Except for one death, the rest were cured and discharged. Conclusion Falciparum malaria is the main infectious species in imported malaria cases, which has many complications. Early identification and diagnosis of malaria is the key to treatment. The phenomenon of increased platelets and decreased hemoglobin after treatment of imported malaria is of significant significance and is worthy of further study. 摘要:目的 分析输人性疟疾患者的临床特征,实验室检査结果及治疗策略,为疟疾防控及诊治提供经验。 方法 收集2012年7月至2019年12月广西医科大学第一附属医院收治的39例输人性疟疾患者的临床资料,对患者的 一般情况、临床表现、实验室检査 、 诊断治疗情况等进行回顾性分析。 结果 39例患者中男性37例,女性2例,平均年 龄(38.79±9.74)岁。其中,恶性疟20例,间日疟3例,恶性疟混合间日疟2例,卵形疟1例,三日疟1例,分型不详12例。所有患者均有发热症状,乏力（占74.36%)、头痛（占33.33%)、脾大（占30.77%)、恶心呕吐（占28.21%)等为常见临床症 状,17例患者出现相关并发症。患者经治疗后血红蛋白水平[(99.94±23.06)g/L]较治疗前[(116.97±28.30)g/L]降低,差异 有统计学意义 t =2.6561, P <0.05),血小板[(209.24±100.31)×10 9 /L]较治疗前[(102.12±86.98)×10 9 /L]升高,差异有统计学 意义( t =-4.6801, P <0.001)。38例患者选用以青蒿琥酯为基础的治疗,除1例恶性疟重症患者死亡外,其余患者治愈出 院。 结论 输人性疟疾感染虫种主要是恶性疟原虫,常合并多种并发症,尽早识别及诊断疟疾是治疗的关键。其治疗 后出现血小板升高和血红蛋白降低具有显著意义,值得进一步研究。","PeriodicalId":10045,"journal":{"name":"中国热带医学","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90531576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.13604/J.CNKI.46-1064/R.2021.01.15
Liao Xin-xin, Z. Yi, Yang Guo-jing, Zhu Ni, Zhou Ticao, M. Lin, Cao Lei
Objective To provide the basis for malaria surveillance to prevent re-transmission after malaria elimination by analyzing the treatment and diagnosis of imported malaria cases in Shaanxi Province during 2015-2019. Methods Data on imported malaria cases in Shannxi Province from 2015 to 2019 were collected and sorted through the National Infectious Diseases Information Reporting Management System (IDIRMS) and the Parasitic Diseases Information Reporting Management System (PDIRMS). The diagnostic methods, primary medical units, laboratory testing institutions and diagnostic timeliness of imported malaria cases were described and analyzed by Chi-square test, Fisher’s exact test and rank-sum test. Results A total of 409 imported malaria cases were reported during 2015-2019 in Shaanxi Province, and all of which were diagnosed with laboratory tests. The rate of utilization RDT increased from 48.56%(36/74) in 2015 to 82.83%(82/99) in 2019. The main primary medical unitswere found to be prefecture level medical (67.97%, 278/409) and county level medical (10.27%, 42/409). There was a significant difference in the upward trend of the correct rate of initial diagnosis of the cases ( χ 2 =15.677, P <0.001). The main laboratory testing institution was prefecture level medical(69.44%, 284/409) while the main reported institution was prefecture level medical (66.99%, 274/409).The median time from onset to diagnosis of malaria cases was 4 days, in which the median time from onset to first visit was 2 day. There was a significant difference in the time from first visit to diagnosis ( χ 2 =25.627, P <0.001), and the interquartile interval of malaria cases was shortened from the longest 4 days in 2015 to the shortest 1 days in 2019. There was a significant difference in the time from first visit to diagnosis among different species of malaria ( χ 2 =9.115, P =0.028), and P. malariae cases (7 days) were the longest than the other species malaria cases. Conclusion To strengthen the health education of key population to improve the awareness of medical treatment, continuously improve the diagnostic awareness and capabilities of medical institutions, and to play the role of sentinel hospitals in the surveillance of preventing re-transmission after malaria elimination. 摘要:目的 分析2015—2019年陕西省输人性疟疾病例诊断的情况,为消除疟疾后防止再传播的监测工作提供依 据。 方法 数据来源于传染病报告信息管理系统和寄生虫病防治信息管理系统,收集整理2015—2019年陕西省报告 的所有疟疾病例信息,对其诊断方式、初诊机构、实验室检测机构、诊断及时性等情况采用 χ 2 检验、Fisher确切概率或秩 和检验进行统计分析。 结果 2015—2019年陕西省共报告输人性疟疾病例409例,均为实验室确诊病例,快速诊断试 剂(RDT)使用率由2015年的48.56%(36/74)提高到2019年的82.83%(82/99)。病例的初诊机构主要为地市级医疗机构 (67.97%,278/409)和县级医疗机构（10.27%, 42/409)。病例的初诊诊断正确率呈上升的趋势,差异有统计学意义( χ 2 =15.677, P <0.001)。实验室检测主要为市级医疗机构(69.44%)。病例的报告机构主要为地市级医疗机构(66.99%)。病 例从发病到确诊时间中位数为4 d,其中发病-初诊时间中位数为2 d,初诊-确诊时间差异有统计学意义( χ 2 =25.627, P <001),其四分位数间距由2015年最长的4 d缩短为2019年的1 d。不同虫种的疟疾病例初诊-确诊时间差异有统计学 意义( χ 2 =9.115, P =0.028),以三日疟的初诊-确诊的中位数最长,为7 d。 结论 加强重点人群的健康教育以提高其就诊 意识,持续提高医疗机构的诊断意识和水平,发挥医疗机构在消除疟疾后防止再传播监测工作中的哨点作用。
{"title":"Diagnosis of imported malaria cases in Shaanxi, 2015-2019","authors":"Liao Xin-xin, Z. Yi, Yang Guo-jing, Zhu Ni, Zhou Ticao, M. Lin, Cao Lei","doi":"10.13604/J.CNKI.46-1064/R.2021.01.15","DOIUrl":"https://doi.org/10.13604/J.CNKI.46-1064/R.2021.01.15","url":null,"abstract":"Objective To provide the basis for malaria surveillance to prevent re-transmission after malaria elimination by analyzing the treatment and diagnosis of imported malaria cases in Shaanxi Province during 2015-2019. Methods Data on imported malaria cases in Shannxi Province from 2015 to 2019 were collected and sorted through the National Infectious Diseases Information Reporting Management System (IDIRMS) and the Parasitic Diseases Information Reporting Management System (PDIRMS). The diagnostic methods, primary medical units, laboratory testing institutions and diagnostic timeliness of imported malaria cases were described and analyzed by Chi-square test, Fisher’s exact test and rank-sum test. Results A total of 409 imported malaria cases were reported during 2015-2019 in Shaanxi Province, and all of which were diagnosed with laboratory tests. The rate of utilization RDT increased from 48.56%(36/74) in 2015 to 82.83%(82/99) in 2019. The main primary medical unitswere found to be prefecture level medical (67.97%, 278/409) and county level medical (10.27%, 42/409). There was a significant difference in the upward trend of the correct rate of initial diagnosis of the cases ( χ 2 =15.677, P <0.001). The main laboratory testing institution was prefecture level medical(69.44%, 284/409) while the main reported institution was prefecture level medical (66.99%, 274/409).The median time from onset to diagnosis of malaria cases was 4 days, in which the median time from onset to first visit was 2 day. There was a significant difference in the time from first visit to diagnosis ( χ 2 =25.627, P <0.001), and the interquartile interval of malaria cases was shortened from the longest 4 days in 2015 to the shortest 1 days in 2019. There was a significant difference in the time from first visit to diagnosis among different species of malaria ( χ 2 =9.115, P =0.028), and P. malariae cases (7 days) were the longest than the other species malaria cases. Conclusion To strengthen the health education of key population to improve the awareness of medical treatment, continuously improve the diagnostic awareness and capabilities of medical institutions, and to play the role of sentinel hospitals in the surveillance of preventing re-transmission after malaria elimination. 摘要:目的 分析2015—2019年陕西省输人性疟疾病例诊断的情况,为消除疟疾后防止再传播的监测工作提供依 据。 方法 数据来源于传染病报告信息管理系统和寄生虫病防治信息管理系统,收集整理2015—2019年陕西省报告 的所有疟疾病例信息,对其诊断方式、初诊机构、实验室检测机构、诊断及时性等情况采用 χ 2 检验、Fisher确切概率或秩 和检验进行统计分析。 结果 2015—2019年陕西省共报告输人性疟疾病例409例,均为实验室确诊病例,快速诊断试 剂(RDT)使用率由2015年的48.56%(36/74)提高到2019年的82.83%(82/99)。病例的初诊机构主要为地市级医疗机构 (67.97%,278/409)和县级医疗机构（10.27%, 42/409)。病例的初诊诊断正确率呈上升的趋势,差异有统计学意义( χ 2 =15.677, P <0.001)。实验室检测主要为市级医疗机构(69.44%)。病例的报告机构主要为地市级医疗机构(66.99%)。病 例从发病到确诊时间中位数为4 d,其中发病-初诊时间中位数为2 d,初诊-确诊时间差异有统计学意义( χ 2 =25.627, P <001),其四分位数间距由2015年最长的4 d缩短为2019年的1 d。不同虫种的疟疾病例初诊-确诊时间差异有统计学 意义( χ 2 =9.115, P =0.028),以三日疟的初诊-确诊的中位数最长,为7 d。 结论 加强重点人群的健康教育以提高其就诊 意识,持续提高医疗机构的诊断意识和水平,发挥医疗机构在消除疟疾后防止再传播监测工作中的哨点作用。","PeriodicalId":10045,"journal":{"name":"中国热带医学","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81895674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.13604/J.CNKI.46-1064/R.2021.01.07
W. Wei-ming, C. Yuan-yuan, Yang Meng-meng, G. Ya-Ping, X. Sui, Z. Hua-yun, Z. Guo-Ding, C. Jun
Objective This paper analyzed 11 cases of severe malaria in Jiangsu Province, summarized the causes of severe malaria, evaluated the effect of diagnosis and treatment, and provided scientific basis for formulating feasible treatment measures of severe malaria. Methods The case information, epidemiological investigation reports and inpatient medical records of 11 severe malaria cases in Jiangsu Province in 2019 were collected from the Infectious Disease Report Information Management System and Parasitic Disease Prevention and Control Information Management System. The onset time, clinical manifestations, diagnosis process and treatment of severe malaria cases were summarized and analyzed. Results Totally 11 cases of severe malaria, including 10 cases of falciparum malaria, and 1 case of ovale malaria, were all imported cases from abroad. The shortest time of living abroad was 22 days, and the longest was 1 070 days. Four cases had malaria while abroad. All of the 10 severe cases of falciparum malaria developed within one month after they returned to China, and three of them became ill on the day they returned home. One severe case of Plasmodium ovale began onset 134 days after returning home. The average time from onset to treatment was 2.5 days, and the average interval time from visit to diagnosis was 1.81 days. There were 3 cases of coma or shock, 3 cases of severe anemia, 4 cases of acute renal failure, and 1 case of acute respiratory distress syndrome. 1 case of Plasmodium ovale had severe anemia due to spontaneous rupture of spleen. Except one case of ovale malaria was treated with dihydroartemisinin piperaquine tablets plus primaquine tablets, the other 10 severe falciparum malaria cases were treated with artesunate injection for antimalarial treatment, and all of them were cured and discharged from hospital after receiving antimalarial treatment. 11 cases of severe cases, the shortest length of stay was 9 days, the longest was 40 days, with an average of 22.64 days; the minimum hospitalization cost was 9 270 yuan, the maximum was 177 174 yuan, with an average of 81 520.76 yuan. Conclusion It is necessary to strengthen multi department cooperation to improve patients’ awareness of timely treatment, strengthen the professional knowledge and professional training of medical staff, find and treat imported malaria cases as soon as possible, so as to prevent severe malaria caused by delayed diagnosis. 摘要:目的 对江苏省11例输入性重症疟疾病例进行分析,总结重症疟疾的成因、评价诊治效果,为制定切实可行 的重症疟疾救治措施提供科学依据。 方法 收集2019年江苏省11例重症疟疾病例传染病报告信息管理系统和寄生 虫病防治信息管理系统的个案信息、流行病学调查报告以及住院病历,对重症疟疾病例的发病时间、临床表现、诊断过 程、治疗情况进行汇总分析。 结果 11例重症疟疾病例中恶性疟10例、卵形疟1例,均为境外输入性病例,在境外生活 时间最短22 d最长1 070 d在国外期间有4例曾患过疟疾。10例恶性疟重症病例均在回国后一个月内发病,其中有 3例在回国当天就发病。1例卵形疟重症病例在回国后134 d才开始发病。11例重症疟疾病例发病至就诊平均时间为 2.5 d,就诊至确诊平均时间为1.81 d。重症表现为昏迷或休克3例、重度贫血3例、急性肾功能衰竭4例、急性呼吸窘迫 综合征1例。1例卵形疟由于出现自发性脾破裂引起重度贫血。除1例卵形疟病例给予双氢青蒿素哌喹片加服伯氨喹 片治疗外,其余10例恶性疟重症病例均采用青蒿琥酯注射抗疟治疗,接受抗疟治疗后均痊愈出院。11例重症病例,住 院天数最短9 d最长40 d平均22.64 d;住院费用最少9 270元,最多177 174元,平均81 520.76元。
目的对江苏省11例重症疟疾病例进行分析，总结重症疟疾发病原因，评价诊疗效果，为制定可行的重症疟疾治疗措施提供科学依据。方法通过传染病报告信息管理系统和寄生虫病预防控制信息管理系统收集2019年江苏省11例重症疟疾病例的病例信息、流行病学调查报告和住院病历。总结分析重症疟疾病例的发病时间、临床表现、诊断过程及治疗方法。结果11例重症疟疾均为境外输入病例，其中恶性疟疾10例，卵圆型疟疾1例。在国外居住时间最短为22天，最长为1070天。4例在国外时感染疟疾。10例恶性疟疾重症病例均在回国后1个月内发病，其中3例在回国当天发病。1例严重卵形疟原虫在回国后134天发病。从发病到治疗的平均时间为2.5天，从就诊到诊断的平均间隔时间为1.81天。昏迷或休克3例，重度贫血3例，急性肾功能衰竭4例，急性呼吸窘迫综合征1例。1例卵形疟原虫自发性脾破裂致严重贫血。除1例卵圆型疟疾患者采用双氢青蒿素哌喹片加伯氨喹片治疗外，其余10例重症恶性疟疾患者均采用青蒿琥酯注射液抗疟治疗，经抗疟治疗后全部治愈出院。重症11例，最短住院时间9天，最长住院时间40天，平均22.64天;住院费用最低为9270元，最高为177174元，平均为81520.76元。结论应加强多部门合作，提高患者及时治疗意识，加强医务人员的专业知识和专业培训，尽早发现和治疗输入性疟疾病例，防止因延误诊断而造成严重疟疾。摘要:目的 对江苏省11例输入性重症疟疾病例进行分析,总结重症疟疾的成因、评价诊治效果,为制定切实可行 的重症疟疾救治措施提供科学依据。 方法 收集2019年江苏省11例重症疟疾病例传染病报告信息管理系统和寄生 虫病防治信息管理系统的个案信息、流行病学调查报告以及住院病历,对重症疟疾病例的发病时间、临床表现、诊断过 程、治疗情况进行汇总分析。 结果11例重症疟疾病例中恶性疟10例,卵形疟1例,均为境外输入性病例,在境外生活时间最短22 d最长1 070 d在国外期间有4例曾患过疟疾。10例恶性疟重症病例均在回国后一个月内发病,其中有 3例在回国当天就发病。1。11 d . 1 d . 1 d . 1 d . 1 d . 1 d . 2 d . 2 d . 2 d . 2 d . 2 d . 2 d . 2 d . 2 d . 2 d . 2 d . 2 d . 2 d . 2 d . 2 d . 2 d . 2 d . 1 d . 2重症表现为昏迷或休克3例、重度贫血3例、急性肾功能衰竭4例、急性呼吸窘迫 综合征1例。1例卵形疟由于出现自发性脾破裂引起重度贫血。除1例卵形疟病例给予双氢青蒿素哌喹片加服伯氨喹 片治疗外,其余10例恶性疟重症病例均采用青蒿琥酯注射抗疟治疗,接受抗疟治疗后均痊愈出院。11例重症病例,住院天数最短9 d最长40 d平均22.64 d;住院费用最少9 270元,最177多174元,平均81 520.76元。结论 应加强多部 门合作,提高患者及时就诊意识;加强医务人员疟疾专业知识和业务的培训,尽早发现输入性疟疾病例并及时治疗,防 止因延误诊断造成的重症疟疾。
{"title":"Analysis of 11 imported severe malaria cases in Jiangsu","authors":"W. Wei-ming, C. Yuan-yuan, Yang Meng-meng, G. Ya-Ping, X. Sui, Z. Hua-yun, Z. Guo-Ding, C. Jun","doi":"10.13604/J.CNKI.46-1064/R.2021.01.07","DOIUrl":"https://doi.org/10.13604/J.CNKI.46-1064/R.2021.01.07","url":null,"abstract":"Objective This paper analyzed 11 cases of severe malaria in Jiangsu Province, summarized the causes of severe malaria, evaluated the effect of diagnosis and treatment, and provided scientific basis for formulating feasible treatment measures of severe malaria. Methods The case information, epidemiological investigation reports and inpatient medical records of 11 severe malaria cases in Jiangsu Province in 2019 were collected from the Infectious Disease Report Information Management System and Parasitic Disease Prevention and Control Information Management System. The onset time, clinical manifestations, diagnosis process and treatment of severe malaria cases were summarized and analyzed. Results Totally 11 cases of severe malaria, including 10 cases of falciparum malaria, and 1 case of ovale malaria, were all imported cases from abroad. The shortest time of living abroad was 22 days, and the longest was 1 070 days. Four cases had malaria while abroad. All of the 10 severe cases of falciparum malaria developed within one month after they returned to China, and three of them became ill on the day they returned home. One severe case of Plasmodium ovale began onset 134 days after returning home. The average time from onset to treatment was 2.5 days, and the average interval time from visit to diagnosis was 1.81 days. There were 3 cases of coma or shock, 3 cases of severe anemia, 4 cases of acute renal failure, and 1 case of acute respiratory distress syndrome. 1 case of Plasmodium ovale had severe anemia due to spontaneous rupture of spleen. Except one case of ovale malaria was treated with dihydroartemisinin piperaquine tablets plus primaquine tablets, the other 10 severe falciparum malaria cases were treated with artesunate injection for antimalarial treatment, and all of them were cured and discharged from hospital after receiving antimalarial treatment. 11 cases of severe cases, the shortest length of stay was 9 days, the longest was 40 days, with an average of 22.64 days; the minimum hospitalization cost was 9 270 yuan, the maximum was 177 174 yuan, with an average of 81 520.76 yuan. Conclusion It is necessary to strengthen multi department cooperation to improve patients’ awareness of timely treatment, strengthen the professional knowledge and professional training of medical staff, find and treat imported malaria cases as soon as possible, so as to prevent severe malaria caused by delayed diagnosis. 摘要:目的 对江苏省11例输入性重症疟疾病例进行分析,总结重症疟疾的成因、评价诊治效果,为制定切实可行 的重症疟疾救治措施提供科学依据。 方法 收集2019年江苏省11例重症疟疾病例传染病报告信息管理系统和寄生 虫病防治信息管理系统的个案信息、流行病学调查报告以及住院病历,对重症疟疾病例的发病时间、临床表现、诊断过 程、治疗情况进行汇总分析。 结果 11例重症疟疾病例中恶性疟10例、卵形疟1例,均为境外输入性病例,在境外生活 时间最短22 d最长1 070 d在国外期间有4例曾患过疟疾。10例恶性疟重症病例均在回国后一个月内发病,其中有 3例在回国当天就发病。1例卵形疟重症病例在回国后134 d才开始发病。11例重症疟疾病例发病至就诊平均时间为 2.5 d,就诊至确诊平均时间为1.81 d。重症表现为昏迷或休克3例、重度贫血3例、急性肾功能衰竭4例、急性呼吸窘迫 综合征1例。1例卵形疟由于出现自发性脾破裂引起重度贫血。除1例卵形疟病例给予双氢青蒿素哌喹片加服伯氨喹 片治疗外,其余10例恶性疟重症病例均采用青蒿琥酯注射抗疟治疗,接受抗疟治疗后均痊愈出院。11例重症病例,住 院天数最短9 d最长40 d平均22.64 d;住院费用最少9 270元,最多177 174元,平均81 520.76元。","PeriodicalId":10045,"journal":{"name":"中国热带医学","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79086146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.13604/j.cnki.46-1064/r.2021.07.13
Yingqi Liu
Objective: To explore the guiding value of dynamic changes of lung ultrasound score (LUS) for respiratory support therapy in patients with severe coronavirus disease 2019(COVID-19).
{"title":"Guiding value of dynamic lung ultrasound score in the respiratory support treatment of severe COVID-19","authors":"Yingqi Liu","doi":"10.13604/j.cnki.46-1064/r.2021.07.13","DOIUrl":"https://doi.org/10.13604/j.cnki.46-1064/r.2021.07.13","url":null,"abstract":"Objective: To explore the guiding value of dynamic changes of lung ultrasound score (LUS) for respiratory support therapy in patients with severe coronavirus disease 2019(COVID-19).","PeriodicalId":10045,"journal":{"name":"中国热带医学","volume":"5 1","pages":"676-680"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76102361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.13604/J.CNKI.46-1064/R.2021.01.22
S. Yue, Xia Yun-lei, Zheng Rong-rong, H. Qian, Yao Li-nong
Objective To analyze the clinical data and drug treatment of malaria patients Xixi Hospital of Hangzhou, February 2014 – December 2019, and we provide reference data for early clinical diagnosis, assessment of severity and treatment, and promote rational clinical medication. Methods A total of 66 malaria patients admitted to hospital from February 2014 to December 2019 were collected to distinguish mild and severe cases. The laboratory test results and drug use of the two groups were compared, and the indicators of the two groups were analyzed by multi-factor binary Logistic Stepwise regression analysis. Results In the treatment of 17 patients with severe falciparum malaria, 10 patients artesunate injection and subsequent dihydroartemisinin-piperaquine tablets were used to consolidate the treatment, and the treatment effect was good. Among 34 patients with mild falciparum malaria, 28 patients were treated with dihydroartemisinin-piperaquine tablets alone, with sensitive effect and high cure rate. For 8 cases of vivax malaria and 4 cases of ovale malaria, 6 patients were treated with chloroquine phosphate plus primaquine phosphate 8-day regimen, and 6 patients were treated with artemisinin-based drugs, and the treatment effect was good. There was statistically significant difference in age, cure time, white blood cells (WBC), red blood cells, hemoglobin, platelets, aspartate transaminase, total bilirubin, C-reactive protein and procalcitonin (PCT) between mild group and severe group ( P <0.05). Multi-factor binary Logistic Stepwise regression analysis showed that the related factors influencing the severity of malaria included age, WBC and PCT. Conclusion Artemisinin-based injections combined with ACTs (Combinatorial therapy) are more effective in treating severe and malignant diseases. Artemisinin alone is effective in the treatment of vivax malaria and ovale malaria in the absence of preferred drugs. There are many factors, such as age, cure time, white blood cells, red blood cells, hemoglobin, platelets, aspartate transaminase, total bilirubin, C-reactive protein and procalcitonin, influencing the severity of malaria, among which age, leukocyte and procalcitonin are of great significance for the prediction and evaluation of malaria severity. 摘要:目的 分析杭州市西溪医院2014年2 月一2019年 12月收治的疟疾患者临床资料及药物治疗情况,为临床早 期诊断、评估轻重以及治疗提供参考数据,促进临床合理用药。 方法 收集2014年 2 月一2019年12月收治人院的66 例疟疾患者资料,分为轻症组和重症组,对两组患者的实验室检测指标结果、药物使用情况进行比较,并采用多因素二 元 Logistic 对两组患者的指标作逐步回归分析。 结果 17 例重症恶性疟患者治疗中, 10 例患者尽早、足量、足疗程使用 青蒿琥酯针及后续双氢青蒿素哌喹片巩固治疗,效果良好。 34 例轻症恶性疟疾患者, 28 例单独使用双氢青蒿素哌喹 片,效果敏感,治愈率高。 8 例间日疟和 4 例卵形疟, 6 例患者使用磷酸氯喹加磷酸伯氨喹八日方案, 6 例患者选用青蒿 素类药物,效果均良好。经Pearson单因素分析,轻症组与重症组在年龄、治愈时间、白细胞、红细胞、血红蛋白、血小板、谷草转氨酶、总胆红素、C-反应蛋白及降钙素原间差异具有统计学意义( P <0.05);经多元 Logistic 回归分析,影响疟疾轻 重症分型的相关因素包括:年龄、白细胞计数、降钙素原。 结论 青蒿素类注射液治疗后联用青蒿素类复方(ACTs)能 更有效治疗重症恶性疟疾。在缺乏首选药物的情况下单用青蒿素类药物治疗间日疟、卵形疟效果良好。影响疟疾发 病后重症化的因素有年龄、治愈时间、白细胞、红细胞、血红蛋白、血小板、谷草转氨酶、总胆红素、C-反应蛋白及降钙素 原,其中年龄、白细胞及降钙素原对疟疾严重程度的预测评估意义重大。
{"title":"Clinical characteristics of 66 imported malaria cases in Xixi Hospital of Hangzhou","authors":"S. Yue, Xia Yun-lei, Zheng Rong-rong, H. Qian, Yao Li-nong","doi":"10.13604/J.CNKI.46-1064/R.2021.01.22","DOIUrl":"https://doi.org/10.13604/J.CNKI.46-1064/R.2021.01.22","url":null,"abstract":"Objective To analyze the clinical data and drug treatment of malaria patients Xixi Hospital of Hangzhou, February 2014 – December 2019, and we provide reference data for early clinical diagnosis, assessment of severity and treatment, and promote rational clinical medication. Methods A total of 66 malaria patients admitted to hospital from February 2014 to December 2019 were collected to distinguish mild and severe cases. The laboratory test results and drug use of the two groups were compared, and the indicators of the two groups were analyzed by multi-factor binary Logistic Stepwise regression analysis. Results In the treatment of 17 patients with severe falciparum malaria, 10 patients artesunate injection and subsequent dihydroartemisinin-piperaquine tablets were used to consolidate the treatment, and the treatment effect was good. Among 34 patients with mild falciparum malaria, 28 patients were treated with dihydroartemisinin-piperaquine tablets alone, with sensitive effect and high cure rate. For 8 cases of vivax malaria and 4 cases of ovale malaria, 6 patients were treated with chloroquine phosphate plus primaquine phosphate 8-day regimen, and 6 patients were treated with artemisinin-based drugs, and the treatment effect was good. There was statistically significant difference in age, cure time, white blood cells (WBC), red blood cells, hemoglobin, platelets, aspartate transaminase, total bilirubin, C-reactive protein and procalcitonin (PCT) between mild group and severe group ( P <0.05). Multi-factor binary Logistic Stepwise regression analysis showed that the related factors influencing the severity of malaria included age, WBC and PCT. Conclusion Artemisinin-based injections combined with ACTs (Combinatorial therapy) are more effective in treating severe and malignant diseases. Artemisinin alone is effective in the treatment of vivax malaria and ovale malaria in the absence of preferred drugs. There are many factors, such as age, cure time, white blood cells, red blood cells, hemoglobin, platelets, aspartate transaminase, total bilirubin, C-reactive protein and procalcitonin, influencing the severity of malaria, among which age, leukocyte and procalcitonin are of great significance for the prediction and evaluation of malaria severity. 摘要:目的 分析杭州市西溪医院2014年2 月一2019年 12月收治的疟疾患者临床资料及药物治疗情况,为临床早 期诊断、评估轻重以及治疗提供参考数据,促进临床合理用药。 方法 收集2014年 2 月一2019年12月收治人院的66 例疟疾患者资料,分为轻症组和重症组,对两组患者的实验室检测指标结果、药物使用情况进行比较,并采用多因素二 元 Logistic 对两组患者的指标作逐步回归分析。 结果 17 例重症恶性疟患者治疗中, 10 例患者尽早、足量、足疗程使用 青蒿琥酯针及后续双氢青蒿素哌喹片巩固治疗,效果良好。 34 例轻症恶性疟疾患者, 28 例单独使用双氢青蒿素哌喹 片,效果敏感,治愈率高。 8 例间日疟和 4 例卵形疟, 6 例患者使用磷酸氯喹加磷酸伯氨喹八日方案, 6 例患者选用青蒿 素类药物,效果均良好。经Pearson单因素分析,轻症组与重症组在年龄、治愈时间、白细胞、红细胞、血红蛋白、血小板、谷草转氨酶、总胆红素、C-反应蛋白及降钙素原间差异具有统计学意义( P <0.05);经多元 Logistic 回归分析,影响疟疾轻 重症分型的相关因素包括:年龄、白细胞计数、降钙素原。 结论 青蒿素类注射液治疗后联用青蒿素类复方(ACTs)能 更有效治疗重症恶性疟疾。在缺乏首选药物的情况下单用青蒿素类药物治疗间日疟、卵形疟效果良好。影响疟疾发 病后重症化的因素有年龄、治愈时间、白细胞、红细胞、血红蛋白、血小板、谷草转氨酶、总胆红素、C-反应蛋白及降钙素 原,其中年龄、白细胞及降钙素原对疟疾严重程度的预测评估意义重大。","PeriodicalId":10045,"journal":{"name":"中国热带医学","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84891485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：