在进口严重疟疾的成年人中,单独的超寄生虫病的预后
Sébastien Gaultier1, Sandrine Houzé2,3, Marc Thellier4
1Université Paris Cité, AP-HP, Hôpital Bichat-Claude Bernard, Service de Médecine Intensive et Réanimation Infectieuse, DMU INVICTUS, 46 rue Henri Huchard, Paris 75018, France.
Journal of travel medicine
|May 26, 2025
概括
进口疟疾患者的隔离性超寄生病与严重结局的低风险有关. 然而,这些患者的免疫抑制和高水平的寄生虫病需要在医院进行密切监测.
科学领域:
- 传染性疾病 传染性疾病
- 热带医学 热带医学
- 临床流行病学临床流行病学
背景情况:
- 超寄生虫病 (HP),定义为寄生虫病>4%,是成年人常见的疟疾严重性标志物.
- 隔离性多寄生虫病 (iHP) 占HP病例的10-40%,但其预后价值仍在争论中.
研究的目的:
- 为了评估隔离性超寄生虫病 (iHP) 的预后意义,在进口Plasmodium falciparum疟疾的成年患者.
- 确定与iHP患者不良结果相关的因素.
主要方法:
- 在大巴黎地区的HP的成年进口P. falciparum疟疾患者的多中心回顾性研究 (2018-2022年).
- iHP被追溯确定;主要结局是使用DOOR的复合测量 (生存,没有器官支持,最短的停留时间).
- 使用负二项式回归分析的HP,iHP和结果之间的关联.
主要成果:
- 在355名HP患者中,有135人 (38%) 患有iHP. iHP独立地与更差结果的风险较低相关 (RR0.56).
- 在iHP组中没有死亡;1.5%需要器官支持.
- 在iHP患者中,免疫抑制 (RR 1.65) 和寄生素血症>10% (RR 1.57) 与更差的结局有关.
结论:
- 在法国进口疟疾病例中,孤立的超寄生病与严重不良事件的低风险有关.
- 免疫抑制和寄生虫血症>10%是iHP患者不良结果的危险因素,需要密切的临床监测.
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