加利福尼亚州和德克萨斯州四个主要医院系统的查加斯病诊断实践
Emily A Kelly1, Jose I Echeverri Alegre2, Katherine Promer3
1Department of Laboratory Medicine, University of California, SanFrancisco, San Francisco, California, USA.
The Journal of infectious diseases
|October 19, 2023
概括
查加斯病的早期诊断对于预防严重并发症至关重要. 这项研究发现,美国主要医院的检测率低,随访不完整,这表明错过了及时治疗的机会.
科学领域:
- 传染性疾病 传染性疾病
- 寄生虫学的寄生虫学
- 公共卫生 公共卫生
背景情况:
- 查加斯病 (CD) 影响了美国大约30万人.
- 在30%的病例中,未经治疗的CD可能会导致严重的心脏和胃肠道问题.
- 早期诊断和抗寄生虫治疗可以预防末端器官损伤.
研究的目的:
- 评估主要医院系统中查加斯病的诊断测试实践.
- 确定查加斯病的诊断和管理中的潜在缺口.
主要方法:
- 来自加利福尼亚州和德克萨斯州四个医院系统 (2016-2020) 的电子健康记录的回顾性审查.
- 进行了描述性分析,以评估测试模式和确认性测试率.
主要成果:
- 470名患者接受了CD的测试,其中心脏指标 (主要是心力衰竭) 占测试的一半以上.
- 美国疾病预防控制中心对不到一半 (47%) 的患者进行了确认性检测.
- 测试主要在老年患者中进行,只有很少的测试是由妇产科医生服务订购的.
结论:
- 主要的医院系统显示,查加斯病诊断测试和不完整的确认测试率很低.
- 风险人群中错过了早期诊断的机会,阻碍了及时治疗和预防疾病进展.
- 需要改进的诊断策略,以促进查加斯病的早期检测和干预.
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