武汉东西湖区输入性疟疾流行病学及临床特点

目的探讨武汉市东西湖区收治的输入性疟疾流行病学和临床特征。方法对2015年2月至2016年12月武汉市医疗救治中心收治的输入性疟疾患者流行病学资料、临床表现、诊治情况等进行描述性分析。结果共收集37例输入性疟疾,恶性疟35例(94.59%),卵形疟2例(5.41%);除发热外,畏寒占54.05%、寒战48.65%、出汗29.73%、头痛37.84%、恶心呕吐62.16%、腹泻18.92%、肌肉酸痛13.51%;此组患者误诊率54.05%;经青蒿琥酯、双氢青蒿素哌喹及伯喹联合治疗,第4d内体温恢复正常者占90.91%,第6d外周血涂片疟原虫检查转阴者占84.38%,至23d累计32例(86.49%)患者治愈出院,复燃1例(2.70%)。结论输入性疟疾以恶性疟为主,患者临床表现复杂多样,并发症多;必须加强疟疾诊断防治知识教育和镜检技能培训和考核,保持对输入疟疾的发现与诊治能力。青蒿素类药物联合治疗输入性疟疾疗效可靠应予坚持。

Epidemiological and clinical characteristics of imported malaria in Dongxihu District of Wuhan City

Objective To study the epidemiological and clinical characteristics of imported malaria in Dongxihu District of Wuhan City.Methods The epidemiological data,clinical manifestations,diagnosis and treatment of imported malaria patients from February 2015 to December 2016 in Wuhan Medical Treatment Center were analyzed.Results A total of 37 cases of imported malaria,including 35 cases of falciparum malaria (94.59％) and 2 cases of ovoid malaria (5.41％) were collected.In addition to fever,chills accounted for 54.05％,trembling 48.65％,sweating 29.73％,headache 37.84％,nausea and vomiting 62.16％,diarrhea 18.92％,muscle pain 13.51％.Misdiagnosis rate was 54.05 ％ in this group of patients.Combined treatment of artesunate,dihydroartemisinin and quetiapine was given.The temperature of 90.91％ patients returned to normal within 4 days,the peripheral blood smear positive for malaria parasite examination turned to negative was 84.38％ by the sixth day,up to 23 days cumulative 32 cases (86.49％) were cured,1 case (2.70％) relapsed.Conclusion The clinical manifestation of imported malaria was mainly caused by falciparum malaria.The clinical manifestations were complicated,with diversity and complications.Education on malaria diagnosis and treatment,and training and assessment of microscopic examination should be strengthened,the ability of malaria detection and diagnosis should be maintained.The combined treatment with Artesunate was of reliable efficacy,and should stick to it.