慢性的なサリシラート中毒と重度のマラリア
M English1, V Marsh, E Amukoye
1Clinical Research Centre, Kenya Medical Research Institue, Kilifi Unit, Kilifi, Kenya.
Lancet (London, England)
|June 22, 1996
まとめ
サリチラート中毒は,アフリカの子供にとって大きな懸念事項であり,しばしば重度のマラリア症状を模倣します. 処方箋外薬で発熱を治療した多くの子どもは,サリチラート濃度が高く,深刻な合併症に繋がった.
科学分野:
- 小児科は小児科です.
- 毒理学 毒理学 毒理学
- 感染症 感染症は感染症です.
背景:
- サリチラートは,開発途上国において,OTC (オーバー・ザ・カウンター) 抗熱剤として広く使用されています.
- 開発途上国は,安全性上の懸念から,子供に対するサリチラート使用を制限しています.
- サリシラート中毒の症状は,アフリカの子供における重度のマラリアと重なり合っている.
研究 の 目的:
- ケニアで重症マラリアを呈する子供におけるサリチラート中毒の発生率と影響を調査する.
- 発熱児のコミュニティにおけるサリシラートを含むOTC医薬品の使用を評価する.
主な方法:
- 確認されたPlasmodium falciparumマラリアと重度の症状で入院した子供 (6ヶ月から10歳) を対象に研究が行われました.
- サリシラート濃度は,血液サンプルで測定されました.
- 熱のコミュニティ管理は,OTC薬物使用に関する家庭調査と母親のインタビューを通じて評価されました.
主要な成果:
- 重度のマラリアを患った143人の子供のうち,129人 (90%) が検出可能なサリチラート濃度を持っていた.
- 6人の子供には,高いサリシラート濃度 (≥20 mg/dL) があり,神経機能障害,代謝性アシドーシス,低血糖症を呈していた.
- OTC薬は一般的な第一線熱の治療法であり,母親の94%がサリチラートを含む製剤を購入し,21%が推奨用量を超えた.
結論:
- サリチラート中毒は,重症マラリアの小児における代謝性アシドーシスおよび低血糖症に寄与したり,原因となる可能性があります.
- この症状の重複は,診断と管理を複雑にし,潜在的に死亡率を増やす可能性があります.
- マラリアが流行している地域では,OTC抗炎症薬に関する賢明な使用と親の教育が不可欠です.
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