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呼吸器疾患で亡くなっているアフリカの子供の解剖における肺疾患:記述的解剖研究
Chifumbe Chintu1, Victor Mudenda, Sebastian Lucas
1University of Zambia-University College London Medical School Research and Training Project, University Teaching Hospital, Lusaka, Zambia.
Lancet (London, England)
|October 18, 2002
まとめ
ザンビアにおける呼吸器疾患による子供の死亡のほとんどは,肺炎や結核などの予防可能な感染症によるものです. HIV陽性児は,肺胞性肺炎と細胞メガロウイルスに罹患するリスクが高く,WHOのガイドラインを更新し,より良い診断を行う必要がある.
科学分野:
- 小児の感染症について
- 呼吸器医学とは
- グローバル・ヘルス グローバル・ヘルス
背景:
- 呼吸器疾患を持つアフリカの子供の特定の死因に関する検死データは限られている.
- ザンビアのルサカにある大学病院で,小児の呼吸器疾患による死亡率を調査する研究が行われました.
研究 の 目的:
- 呼吸器疾患を呈する子供の死亡の原因となる特定の肺疾患を決定する.
- 発見を年齢とヒト免疫不全ウイルス1型 (HIV-1) ステータスによって層分けする.
主な方法:
- 1ヶ月から16歳までの264人の子供 (137人の男の子,127人の女の子) の胸腔に検死が行われました.
- 子どもたちは,年齢とHIV-1ステータス (陽性または陰性) によって分類されました.
主要な成果:
- 急性発熱性肺炎 (39.1%),Pneumocystis carinii肺炎 (27.5%),結核 (18.8%),およびサイトメガロウイルス (CMV) 感染 (20.2%) が最も一般的な発見でした.
- HIV-1陽性児は,Pneumocystis carinii肺炎 (OR 5.28),CMV (OR 7.71) およびショック肺 (OR 4.15) の割合が著しく高かった.
- 結核は,すべての年齢層とHIV-1ステータスにおいて流行していた.
結論:
- 小児の呼吸器疾患による死亡のほとんどは,治療可能な感染性物質によるものです.
- 複数の疾患の頻繁な同時発生は,診断を複雑にします.
- 更新された世界保健機関 (WHO) のガイドラインとバクテリア病原体,結核,Pneumocystis carinii肺炎の診断ツールの改善は,特にHIV-1陽性子供にとって極めて重要です.
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