苏丹热带病教学医院内脏利什曼病临床表现差异评估

Hammam Abdalrhman Altom Mohammed Ahmed, Ahmed Ali Ahmed Musa, Ahmed Mahmoud, Sayed Sayedahmed, Shiraz Bashir Jabralseed Mohammed, Ehssan Farouk Mohamed Ahmed, Anas Mohamed, A. Nail
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摘要

背景:内脏利什曼病(又称黑热病)是一种具有多种临床表现的全身性寄生虫感染。本研究评估了在苏丹喀土穆的热带病教学医院(TDTH)就诊的患者的表现差异。方法:在2019年11月至2020年9月期间,在TDTH进行了这项基于医院的横断面分析研究。使用结构化数据提取检查表对在TDTH就诊的患者的医疗记录进行了审查。卡方检验用于确定社会人口学与患者临床表现之间的关系。p值< 0.05认为有统计学意义。结果:195例患者中男性占79.5%,年龄<31岁占48.2%。发热为主要临床表现(90.2%),体重减轻为53.3%,脾肿大和肝肿大分别为72.3%和39%。4.6%的患者被检测出艾滋病毒。RK39是主要的诊断试验。我们发现腹胀与患者的年龄有显著相关性(P < 0.05), 11-20岁和41-50岁年龄组比其他年龄组更容易出现腹胀。结论:没有确切的临床表现或常规实验室结果是内脏利什曼病的病理特征;因此,在任何有发热、体重减轻、腹胀的患者和艾滋病毒感染者的鉴别诊断中都应考虑到这一点。
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Assessment of Variation in Clinical Presentation of Visceral Leishmaniasis Among Patients Attending the Tropical Diseases Teaching Hospital in Sudan
Background: Visceral leishmaniasis (also known as Kala-azar) is a systemic parasitic infection with many clinical presentations. The present study assesses the variation in presentations among patients who attended the Tropical Diseases Teaching Hospital (TDTH) in Khartoum, Sudan. Methods: This analytical cross-sectional, hospital-based study was conducted at the TDTH between November 2019 and September 2020. Medical records of patients who presented at the TDTH were reviewed using a structured data extraction checklist. The Chi-square test was used to determine the associations between sociodemographic and clinical presentations of patients. P-value < 0.05 was considered as statistically significant. Results: Out of 195 patients, 79.5% were male and 48.2% were <31 years old. Fever was the main clinical presentation (90.2%) while 53.3% presented with weight loss and 72.3% and 39% presented, respectively, with splenomegaly and hepatomegaly. HIV was detected in 4.6% of the patients. RK39 was the main diagnostic test. We found a significant association between the abdominal distention and the age of the patients (P < 0.05) – age groups 11–20 and 41–50 years were more likely to present with abdominal distention than other age groups. Conclusion: There is no exact clinical presentation or routine laboratory findings that are pathognomonic for visceral leishmaniasis; therefore, it should be considered in the differential diagnosis of any patient with fever, weight loss, and abdominal distention, and among patients with HIV.
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