在疟疾流行国家停留后到急诊科就诊的旅行者中的输入性疾病:一项回顾性观察研究

IF 2.4 Q3 INFECTIOUS DISEASES Tropical Diseases, Travel Medicine and Vaccines Pub Date : 2023-02-20 DOI:10.1186/s40794-023-00190-0
Sofie Desmet, Liesbet Henckaerts, Sien Ombelet, Benjamin Damanet, Peter Vanbrabant
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引用次数: 0

摘要

背景:我们的目的是调查到疟疾流行国家旅行后到急诊科就诊的患者的病因和疾病结局,以提高对热带和世界性疾病的认识。方法:对2017年至2020年在鲁汶大学医院急诊科接受疟疾血液涂片检查的所有患者进行回顾性图表回顾。收集和分析患者特征、实验室和放射检查结果、诊断、病程和转归。结果:共纳入253例患者。大多数患病旅行者来自撒哈拉以南非洲(68.4%)和东南亚(19.4%)。诊断为全身性发热病(30.8%)、不明原因炎症综合征(23.3%)和急性腹泻(18.2%)3大类。疟疾(15.8%)是全身性发热性疾病患者最常见的特异性诊断,其次是流感(5.1%)、立克次体病(3.2%)、登革热(1.6%)、肠热(0.8%)、基孔肯雅热(0.8%)和钩端螺旋体病(0.8%)。高胆红素血症和血小板减少症的存在增加了疟疾的可能性,似然比分别为4.01和6.03。7例患者(2.8%)在重症监护室接受治疗,无患者死亡。结论:全身性发热性疾病、不明原因的炎症综合征和急性腹泻是疟疾流行国家回国后到我急诊科就诊的旅行者的三个主要症状类别。疟疾是全身性发热性疾病患者最常见的特异性诊断。没有患者死亡。
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Imported diseases in travellers presenting to the emergency department after a stay in a malaria-endemic country: a retrospective observational study.

Background: We aimed to investigate the aetiology and outcomes of illnesses in patients presenting to an emergency department after travelling to a malaria-endemic country, in order to raise awareness of both tropical and cosmopolitan diseases.

Methods: A retrospective chart review was performed for all patients who underwent blood smear testing for malaria at the Emergency Department of the University Hospitals Leuven from 2017 to 2020. Patient characteristics, results of laboratory and radiological examinations, diagnoses, disease course and outcome were collected and analysed.

Results: A total of 253 patients were included in the study. The majority of ill travellers returned from Sub-Saharan Africa (68.4%) and Southeast Asia (19.4%). Their diagnoses fell into three major syndrome categories: systemic febrile illness (30.8%), inflammatory syndrome of unknown origin (23.3%) and acute diarrhoea (18.2%). Malaria (15.8%) was the most common specific diagnosis in patients with systemic febrile illness, followed by influenza (5.1%), rickettsiosis (3.2%), dengue (1.6%), enteric fever (0.8%), chikungunya (0.8%) and leptospirosis (0.8%). The presence of hyperbilirubinemia and thrombocytopenia increased the probability of malaria, with a likelihood ratio of 4.01 and 6.03, respectively. Seven patients (2.8%) were treated in the intensive care unit, and none died.

Conclusion: Systemic febrile illness, inflammatory syndrome of unknown origin and acute diarrhoea were the three major syndromic categories in returning travellers presenting to our emergency department after a stay in a malaria-endemic country. Malaria was the most common specific diagnosis in patients with systemic febrile illness. None of the patients died.

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来源期刊
CiteScore
5.20
自引率
0.00%
发文量
25
审稿时长
17 weeks
期刊介绍: Tropical Diseases, Travel Medicine and Vaccines is an open access journal that considers basic, translational and applied research, as well as reviews and commentary, related to the prevention and management of healthcare and diseases in international travelers. Given the changes in demographic trends of travelers globally, as well as the epidemiological transitions which many countries are experiencing, the journal considers non-infectious problems including chronic disease among target populations of interest as well as infectious diseases.
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