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塞拉利昂埃博拉出血热死亡病例流行病学特征分析 被引量:1
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作者 伍晨 张义雄 +8 位作者 Meesaq Ahmad 谭波宇 袁子杰 张渝 蔡翊 李妍妍 彭韵玲 王斌 James Bangalie Turay 《中国全科医学》 CAS 北大核心 2019年第26期3154-3159,共6页
背景 2014年3月—2015年10月,塞拉利昂暴发埃博拉出血热(EVD),造成累计确诊病例8 690例,死亡3 588例。了解EVD死亡病例流行病学特征对于提高抗疫能力,减少灾害损失意义重大。目的 分析EVD死亡病例的流行病学特征。方法 采用回顾性分析方... 背景 2014年3月—2015年10月,塞拉利昂暴发埃博拉出血热(EVD),造成累计确诊病例8 690例,死亡3 588例。了解EVD死亡病例流行病学特征对于提高抗疫能力,减少灾害损失意义重大。目的 分析EVD死亡病例的流行病学特征。方法 采用回顾性分析方法,病例信息来源于2014年3月—2015年10月Jui GovernmentHospital确诊病例,同时参考塞拉利昂国家埃博拉疫情报告中心(http://www.nerc.sl/)及世界卫生组织(WHO)(http://www.who.int/csr/disease/ebola/en/)记录的数据。收集Jui Government Hospital、塞拉利昂国家埃博拉疫情报告中心、WHO记录的所有发病及死亡患者信息,分析其发病率、死亡率及死亡时间、地域分布;收集Jui Government Hospital确诊患者的病例资料,包括:性别、年龄、起病到入院时间、病毒载量、临床症状、住院时间、出院或死亡时间等。共收集747例患者的病例资料,根据预后分为存活442例,死亡305例。结果 2014年3月—2015年10月,约有8 690例(同期塞拉利昂总人数7 120 722人)确诊EVD,其中死亡3 588例,发病率为0.12%,病死率为41.28%。2014-03-31,塞拉利昂卫生部报告了6例可能和可疑病例,其中死亡5例(病死率为5/6)。2014年9月下降至较低水平〔29.94%(605/2 021)〕,至2014年12月后基本平稳于较低值。首都弗里敦EVD病死率较低〔38.88%(1 341/3 449)〕;距离首都较近的地区EVD病死率较低,距离首都较远的地区EVD病死率较高。死亡患者年龄、起病到入院时间、乏力、腹痛、呼吸困难、皮疹、意识模糊发生率高于存活患者,病毒载量(CT值)、发热、呕吐、厌食、关节痛低于存活患者(P<0.05)。多因素Logistic回归分析结果显示,起病到入院时间〔OR=1.510,95%CI(1.373,1.661)〕、病毒载量(CT值)〔OR=0.937,95%CI(0.892,0.985)〕、呕吐〔OR=0.576,95%CI(0.343,0.966)〕、乏力〔OR=0.162,95%CI(0.049,0.533)〕、呼吸困难〔OR=1.715,95%CI(1.025,2.871)〕及意识模糊〔OR=0.389,95%CI(0.217,0.696)〕是EVD患者预后的独立影响因素(P<0.05)。结论 影响埃博拉感染病例死亡的因素中,国际援助被认为是减少死亡案例的关键。交通条件可能是影响死亡率的主要因素之一,较早的到达医院治疗会改善埃博拉出血热的预后。老年患者死亡风险较高。临床特征如呕吐、乏力、呼吸困难、昏迷等和预后有相关性。 展开更多
关键词 出血热 埃博拉 埃博拉病毒 塞拉利昂 流行病学研究
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Clinical presentations and outcomes of patients with Ebola virus disease in Freetown, Sierra Leone
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作者 Ying-Jie Ji Xue-Zhang Duan +14 位作者 Xu-Dong Gao Lei Li Chen Li Dong Ji Wen-Gang Li Li-Fu Wang Yu-Hua Meng Xiao Yang Bin-Fang Ling Xue-Ai Song Mei-Lei Gu Tao Jiang She-Ku MKoroma James Bangalie Hui-Juan Duan 《Infectious Diseases of Poverty》 SCIE 2016年第1期933-942,共10页
Background:Clinical and laboratory data were collected and analysed from patients with Ebola virus disease(EVD)in Jui Government Hospital in Freetown,Sierra Leone,where patients with EVD were received and/or treated f... Background:Clinical and laboratory data were collected and analysed from patients with Ebola virus disease(EVD)in Jui Government Hospital in Freetown,Sierra Leone,where patients with EVD were received and/or treated from October 1,2014 to March 21,2015 during the West Africa EVD outbreak.Methods:The study admitted 285 patients with confirmed EVD and followed them up till the endpoint(recovery or death).EVD was confirmed by quantitative RT-PCR assays detecting blood Ebola virus(EBOV).Results:Among the 285 lab-confirmed EVD cases in Jui Government Hospital,146 recovered and 139 died,with an overall survival rate of 51.23%.Patients under the age of 6 years had a lower survival rate(37.50%).Most non-survivors(79.86%)died within 7 days after admission and the mean hospitalization time for non-survivors was 5.56±6.11 days.More than half survivors(63.69%)turned blood EBOV negative within 3 weeks after admission and the mean hospitalization time for survivors was 20.38±7.58 days.High blood viral load(≥106 copies/ml)was found to be predictive of the non-survival outcome as indicated by the Receiver Operating Characteristic(ROC)curve analysis.The probability of patients’survival was less than 15%when blood viral load was greater than 106 copies/ml.Multivariate analyses showed that blood viral load(P=0.005),confusion(P=0.010),abdominal pain(P=0.003),conjunctivitis(P=0.035),and vomiting(P=0.004)were factors independently associated with the outcomes of EVD patients.Conclusions:Most death occurred within 1 week after admission,and patients at the age of 6 or younger had a lower survival rate.Most surviving patients turned blood EBOV negative within 1–4 weeks after admission.Factors such as high blood viral load,confusion,abdominal pain,vomiting and conjunctivitis were associated with poor prognosis for EVD patients. 展开更多
关键词 Ebola virus disease Ebola virus MORTALITY
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