卢旺达儿童疟疾406例临床分析

目的：了解中非国家卢旺达儿童疟疾现状，临床特征及治疗方法。方法：对406例确诊为疟疾的患儿流行病学特点和临床特征进行分析，对疗效进行观察。结果：全年住院患儿766例，其中疟疾患儿406例，患病率53．0％，各月疟疾患病人数间无明显差异。406例疟疾患儿学龄前303例，占74．6％；年长儿103例，占25．4％。不规则发热218例，占53．7％；稽留热109例，占26．8％；出现贫血者126例，占31．3％；有吐泻者199例，占49．0％；有呼吸道症状体征者106例，占26．1％；脾大123例，占30．3％；肝大86例，占21．2％；昏迷4例，占1．0％；死亡21例，占5．1％。406例经静脉滴注二盐酸奎宁及对症治疗5～7d，治愈385例，有效率94．8％。结论：卢旺达儿童疟疾患病率高，发病无明显季节性，恶性疟疾呈现高发病率，死亡率高。住院患儿以学龄前儿童居多，临床以不规则发热和稽留热占大多数。胃肠型、贫血和肝脾肿大发生率高，部分患儿有呼吸道症状体征是一特点，静脉用奎宁是抗疟疾治疗的主要方法。

The Clinical Analysis of 406 Malaria Children in Rwanda

Objective:To investigate the present conditions,clinical characteristics and treatments of malaria children in Rwanda.Methods:The epidemiological and clinical characteristics in 406 malaria cases were analyzed and the effect of treatment was evaluated.Results:There were 406 malaria cases in 766 hospitalized children all year (53 0%).There were no significant differences in the amount of malaria patients among months.In the 406 malaria cases,there were 303 preschool children (74 6%),103 elder children (25 4%).Symptom included irregular fever in 218 cases (53 7%),continued fever in 109 cases (26 8%),anemia in 126 cases (31 3%),vomiting and diarrhed in 199 cases(49.0%),sympton and sign of respiratory tract in 106 cases(26.1%),splenomegaly in 123 cases (30 3%),hepatomegaly in 86 cases (21 2%) and coma in 4 case (1 0%).The mortality was 5 1%.406 cases were treated with Quinine Dihydrochloridum intravenous for 5 and 7 days.The effective rate was 94 5%.Conclusion:The incidence of malaria is higher in Ruarda,and has no seasonal change.The incidence and mortality of malignant malaria are much higher.The preschool children with malaria are the majority in hospital.The common clinical manifestations are irregular and continued fever.The incidences of gastrointestinal,anemia,hepatomegaly and splenomegaly are higher.The sign of respiratory tract is one of clinical characteristics in some cases.The intravenous Quinine is main treatment for malaria.