奇孔古尼亚和登革热的症状重叠:在疫情期间的诊断挑战
Marini Lino Brancini1, Felipe Costa Trida Sene1, Tamires Fernanda Pereira Dos Santos1
1Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto, SP, Brazil.
Acta tropica
|March 13, 2026
概括
由于症状重叠,区分登革热和 chikungunya 是一个挑战. 特定的诊断测试对于准确的识别至关重要,当这些arboviruses共同循环,因为单独的临床表现往往是不够的.
科学领域:
- 亚博病毒学 亚博病毒学
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 登革热和 chikungunya 病毒经常共同循环,呈现类似的症状,使临床诊断复杂化.
- 巴西的圣何塞德里奥普雷托 (São José do Rio Preto) 在2023年11月经历了首次奇孔古尼亚疫情,影响了公共卫生监测和患者分拣.
研究的目的:
- 为了比较登革热和 chikungunya 病例在联合循环期间的临床和综合征概况.
- 为了确定登革热与奇孔古尼亚的不同临床标志物和严重性指标.
- 评估临床表现的诊断准确性,以区分登革热和奇孔古尼亚热.
主要方法:
- 从2023年11月到2024年8月进行了一项回顾性,基于医院的横截面研究.
- 分析了1,819名患者的临床数据,将临床变量与RT-qPCR确认整合在一起.
- 神经病例被单独描述性地分析.
主要成果:
- 在1819名患者中,223人呈阳性登革热检测结果,144人为 chikungunya.
- 这两种疾病之间重叠了14种临床表现.
- 登革热病例更频繁地显示出发烧,头痛,吐,眼睛疼痛,血小板减少和白血病.
- 奇孔古尼亚病例更频繁地呈现出皮疹和关节痛.
- 在登革热患者中,警告信号更为普遍.
结论:
- 登革热和 chikungunya 之间的显著临床重叠限制了仅仅基于症状的诊断准确性.
- 虽然存在一些区分特征,但病毒学确认对于共同循环环境中的确诊诊断至关重要.
- 有效的监测和分类需要对 arboviruses 进行特定的诊断测试能力.
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