也门 2019-2020 年小儿白喉疫情的临床表现和结果

IF 0.2 Q4 PEDIATRICS
Omar Abdul-Rahman Bawazir Bawazir, Noor Abdulaziz Binkroom, Abdulla Salem Binghouth
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引用次数: 0

摘要

背景 白喉是一种急性细菌性传染病,发病率和死亡率都很高。尽管实施了国家疫苗接种计划,但发展中国家仍不断爆发白喉疫情。为避免灾难性后果,需要接种疫苗、及早发现疾病并进行适当干预。目的 描述也门 2019-2020 年白喉暴发期间儿童白喉的临床表现及其与预后的关系。方法 这是一项回顾性研究,旨在评估 2019 年 9 月至 2020 年 5 月白喉爆发期间穆卡拉妇幼医院收治的白喉患者的人口统计学、临床特征和儿科呼吸道白喉的治疗效果。我们使用 SPSS 22 版本进行数据分析。结果 本研究共纳入 34 例经培养确诊的白喉病例,他们的年龄从 13 个月到 15 岁不等。大多数病例(76.5%)发生在 5 岁以上的儿童身上。没有性别差异。在这 34 例白喉阳性病例中,79.4% 来自哈德拉毛省,17.6% 来自沙卜瓦省。大多数病例(35.3%)是在 12 月份入院的。一半以上的患者(52.9%)未接种疫苗。所有患者均出现发热、咽喉痛和扁桃体肿大,部分患者还出现吞咽困难(82.4%)、假膜(91.7%)、牛颈(52.9%)和喘鸣(8.8%)。并发症包括急性肾衰竭(20.6%)、弥散性血管内凝血(DIC)、休克(17.6%)和心肌炎(8.8%)。牛颈症、心肌炎、急性肾功能衰竭、DIC 和休克的预后明显较差(P< 0.05)。病死率(CFR)为 20.6%。结论 发烧、咽喉痛、扁桃体炎、假膜和牛颈是白喉的高度怀疑指标,预示着不祥的结果。白喉发病率向高年龄组转移表明,除了改进和加强当前的免疫计划外,还需要加强白喉类毒素疫苗接种。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical spectrum and outcomes of the 2019-2020 pediatric diphtheria outbreak in Yemen
Background Diphtheria is an acute bacterial infectious disease characterized by serious morbidity and mortality. Outbreaks continue to occur in developing countries despite national vaccination programs. Vaccination, early recognition the disease, and adequate intervention are needed to avoid devastating outcomes. Objective To describe the clinical spectrum of childhood diphtheria and its association to outcomes during the 2019-2020 diphtheria outberak in Yemen. Methods This was a retrospective study to assess the demographic, clinical features, and outcomes of paediatric respiratory diphtheria in patients with diphtheria during the outbreak from September 2019 until May 2020 admitted at Mukalla Maternity and Children Hospital. We used SPSS 22 version for data analysis. Results There were 34 culture-confirmed diphtheria cases included in this study, their age ranged from 13 months to 15 years old. Most of the cases (76.5%) happened to children at more than 5 years old. There was no gender difference. Of these 34-positive diphtheria, 79.4% from Hadramout and 17.6% from Shabwa governorate. Most of the cases (35.3%) were admitted in December. More than half of the patients (52.9%) were unimmunized. Fever, sore throat, and enlarged tonsils were presented in all patients, dysphagia (82.4 %), pseudomembrane (91.7%), bull neck (52.9%), and stridor (8.8%) were also found in some patients. Complications included acute renal failure (20.6%), disseminated intravascular coagulation (DIC), shock (17.6%), and myocarditis (8.8%). Significant poor outcome (P< 0.05) was associated with bull neck, myocarditis, acute renal failure, DIC, and shock. The case fatality rate (CFR) was 20.6%. Conclusion Fever, sore throat, tonsillitis, pseudomembrane, and bull neck are high index suspicion of diphtheria and anticipation of ominous outcome. The shifting of occurrence of diphtheria to older age group indicates the need for booster(s) diphtheria toxoid vaccine in addition to improving and strengthening the current immunization program.
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CiteScore
0.40
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0.00%
发文量
58
审稿时长
24 weeks
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