刚果(金)维和任务区362例疟疾病例的发病特征及基于青蒿素的治疗效果

Characteristics and artemisinin based treatment effect of 362 malaria cases in the peacekeeping mission area of the Democratic Republic of the Congo

目的分析刚果(金)维和任务区疟疾的发病特征和诊治情况, 同时评价基于青蒿素的联合疗法(ACT)的效果, 为疟疾的诊断及治疗提供临床依据。方法收集2014年1月至2020年9月联合国刚果(金)稳定特派团(MONUSCO)中国二级医院收治的感染疟疾维和人员的临床资料, 回顾性分析患者一般资料、发病特点、治疗及临床结局等情况。结果 2014年1月至2020年9月, 362例维和人员因感染疟疾住院, 年均发病例数为54例/年, 年发病率为9.5/1 000, 从发病到明确诊断的时间中位数为2.5 d, 范围为1 ~ 9 d;患者中, 重症疟疾占7.73%(28/362), 非复杂性疟疾占92.27%(334/362);旱季(4 - 9月)发病占37.57%(136/362), 雨季(10月至次年3月)发病占62.43%(226/362)。使用ACT抗疟治疗后均临床治愈, 其中8例出现复燃, 经药物转换ACT再次治疗后临床治愈。结论在刚果(金)维和任务区, 维和人员对疟疾普遍易感, 在临床治疗中采用ACT, 治愈率高, 安全高效。

Objective To analyze the epidemiological characteristics,diagnosis and treatment of malaria in the peacekeeping mission area of the Democratic Republic of the Congo(DRC),and to evaluate the efficacy of artemisinin based combination therapy(ACT),to provide clinical basis for the diagnosis and treatment of malaria.Methods The clinical data of malaria-infected peacekeepers admitted to the Chinese Secondary Hospital of the United Nations Stabilization Mission in DRC(MONUSCO)from January 2014 to September 2020 were collected,and the general information,incidence characteristics,treatment and clinical outcomes of the patients were retrospectively analyzed.Results From January 2014 to September 2020,362 peacekeepers were hospitalized with malaria,the average annual incidence case was 54 cases per year,and the annual incidence was 9.5/1000,with a median of 2.5 days(1-9 days)from onset to diagnosis.Severe malaria accounted for 7.73%(28/362)and uncomplicated malaria accounted for 92.27%(334/362).The incidence rate was 37.57%(136/362)in the dry season(April to September)and 62.43%(226/362)in the rainy season(October to March of the following year).After ACT antimalarial treatment,all patients were cured clinically.Eight cases recurred and were cured clinically after drug conversion ACT retreatment.Conclusions In the peacekeeping mission area of DRC,peacekeepers are generally susceptible to malaria.ACT has a high cure rate,safety and efficiency in clinical treatment.