患有内脏利什曼病的苏丹小儿患者的血液学特征和多诺万利什曼寄生虫载量预测。

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL World Journal of Clinical Cases Pub Date : 2024-10-26 DOI:10.12998/wjcc.v12.i30.6374
Zeinab Ibrahim Ahmed Elnoor, Omaima Abdelmajeed, Alamin Mustafa, Thuraya Gasim, Shima Algam Mohamed Musa, Abdelrahman Hamza Abdelmoneim, Islamia Ibrahim Ahmed Omer, Hiba Awadelkareem Osman Fadl
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引用次数: 0

摘要

背景:内脏利什曼病(VL)是由唐诺瓦利什曼原虫(L. Donovani)引起的一种全身性原虫感染,通过沙蝇传播,引起肝脏、脾脏和骨髓的巨噬细胞侵袭。目前,VL 的诊断依据是临床体征、症状、特异性体外标记物和骨髓检查。目的:研究苏丹儿童 VL 患者的血液和骨髓特征:这是一项以医院为基础的回顾性研究,抽取了107名连续的苏丹儿科患者。数据主要集中在血液和骨髓结果上。我们仅收录了苏丹喀土穆热带病教学医院 2016 年至 2020 年期间 VL 儿童患者的完整病历:本研究纳入的大多数儿科患者年龄在5岁以下(n = 59,55.2%)。此外,贫血、血小板减少和白细胞减少也是研究对象的普遍特征。为了进一步分析数据,我们使用助推森林算法开发了一个机器学习模型来预测唐诺瓦尼寄生虫载量,训练数据集的平均准确率为 0.88,验证数据集中轻度、中度和重度唐诺瓦尼寄生虫载量的准确率分别为 0.46、0.50 和 0.74:本研究表明,苏丹嗜血病毒感染儿童最常见的骨髓变化是慢性炎症细胞增多(88 个,82.2%),并伴有巨噬嗜血细胞(103 个,96.3%)。贫血和血小板减少是最常见的血液学变化。这些结果有望为苏丹儿童疑似 VL 患者提供早期诊断和更好的治疗。
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Hematological picture of pediatric Sudanese patients with visceral leishmaniasis and prediction of leishmania donovani parasite load.

Background: Visceral leishmaniasis (VL) is a systemic protozoan infection caused by Leishmania donovani (L. donovani) and transmitted by sand flies, causing macrophage invasion in the liver, spleen, and bone marrow. Diagnosis of VL is currently based on clinical signs, symptoms, and specific in-vitro markers and bone marrow investigations. However, VL's specific hematological and bone marrow manifestation in Sudanese pediatric patients is not well studied.

Aim: To examine the blood and bone marrow characteristics in pediatric patients from Sudan who have VL.

Methods: This is a retrospective hospital-based study with a sample of 107 consecutive Sudanese pediatric patients. The data focused on hematological and bone marrow results. We included only the completed records of the pediatric patients with VL in the Tropical Disease Teaching Hospital in Khartoum, Sudan from the period of 2016 to 2020.

Results: The majority of pediatric patients included in this study are below 5-years-old (n = 59, 55.2%). Moreover, anemia, thrombocytopenia, and leukopenia were among the prevalent characteristics in the population under study. To further analyze the data, we developed a machine learning model using boosted forest algorithms to predict L. donovani parasites load, with a mean accuracy of 0.88 for the training dataset and an accuracy of 0.46, 0.50, and 0.74 for mild, moderate, and severe L. donovani parasite load in the validation dataset.

Conclusion: This study shows that the most common bone marrow change among Sudanese VL children was increased chronic inflammatory cells (n = 88, 82.2%) with present macrophage hemophagocytes (n = 103, 96.3%). While anemia and thrombocytopenia were the most common hematological changes. These results will hopefully lead to an early diagnosis and hence better management for Sudanese pediatric patients with suspected VL.

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World Journal of Clinical Cases
World Journal of Clinical Cases Medicine-General Medicine
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期刊介绍: The World Journal of Clinical Cases (WJCC) is a high-quality, peer reviewed, open-access journal. The primary task of WJCC is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of clinical cases. In order to promote productive academic communication, the peer review process for the WJCC is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCC are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in clinical cases.
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