BACKGROUND:Increasing numbers of aging individuals with chronic co-morbidities travel to regions where falciparum malaria is endemic. Non-communicable diseases are now leading risk factors for death in such countries. Thus, the influence of chronic diseases on the outcome of falciparum malaria is an issue of major importance. Aim of the present study was to assess whether non-communicable diseases increase the risk for severe imported falciparum malaria.
METHODS:A retrospective observational study of all adult cases with imported falciparum malaria hospitalized between 2001 and 2015 in the tertiary care Charité University Hospital, Berlin, was performed.
RESULTS:A total of 536 adult patients (median age 37 years; 31.3% female) were enrolled. Of these, 329 (61.4%) originated from endemic countries, 207 patients (38.6%) from non-endemic regions. Criteria for severe malaria were fulfilled in 68 (12.7%) cases. With older age, lack of previous malaria episodes, being a tourist, and delayed presentation, well-characterized risk factors were associated with severe malaria in univariate analysis. After adjustment for these potential confounders hypertension (adjusted odds ratio aOR, 3.06 95% confidence interval, CI 1.34-7.02), cardiovascular diseases (aOR, 8.20 95% CI 2.30-29.22), and dyslipidaemia (aOR, 6.08 95% CI 1.13-32.88) were individual diseases associated with severe disease in multivariable logistic regression. Hypertension proved an independent risk factor among individuals of endemic (aOR, 4.83, 95% CI 1.44-16.22) as well as of non-endemic origin (aOR, 3.60 95% CI 1.05-12.35).
CONCLUSIONS:In imported falciparum malaria hypertension and its related diseases are risk factors for severe disease.
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【Hypertension is associated with an increased risk for severe imported falciparum malaria: a tertiary care hospital based observational study from Berlin, Germany.].
【高血压与严重输入性恶性疟疾的风险增加相关：来自德国柏林的一家三级医院的观察性研究。】
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DOI：10.1186/s12936-019-3007-4文章类型：杂志文章
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背景：越来越多的具有慢性合并症的衰老个体前往恶性疟疾流行的地区。在这些国家，非传染性疾病目前是导致死亡的主要危险因素。因此，慢性疾病对恶性疟疾后果的影响是一个非常重要的问题。本研究的目的是评估非传染性疾病是否会增加严重输入性恶性疟疾的风险。
方法：对2001年至2015年在柏林Charité大学医院的三级医院住院的所有输入性恶性疟原虫进行回顾性观察研究。
结果：共纳入536名成年患者（中位年龄37岁；女性31.3％）。其中，329例（61.4％）来自地方病国家，207例患者（38.6％）来自非地方病地区。 68例（12.7％）符合严重疟疾标准。随着年龄的增长，缺乏先前的疟疾发作，成为旅游者以及出现病情延迟，在单因素分析中，特征明确的危险因素与严重的疟疾有关。在对这些潜在的混杂因素进行调整后，高血压（调整后的优势比aOR，3.06 95％置信区间，CI 1.34-7.02），心血管疾病（aOR，8.20 95％CI 2.30-29.22）和血脂异常（aOR，6.08 95％CI 1.13- 32.88）是多变量Logistic回归中与重症相关的个别疾病。高血压被证明是地方性（aOR，4.83，95％CI 1.44-16.22）和非地方性起源（aOR，3.60 95％CI 1.05-12.35）个体的独立危险因素。
结论：在输入的恶性疟疾中，高血压及其相关疾病是严重疾病的危险因素。
方法：对2001年至2015年在柏林Charité大学医院的三级医院住院的所有输入性恶性疟原虫进行回顾性观察研究。
结果：共纳入536名成年患者（中位年龄37岁；女性31.3％）。其中，329例（61.4％）来自地方病国家，207例患者（38.6％）来自非地方病地区。 68例（12.7％）符合严重疟疾标准。随着年龄的增长，缺乏先前的疟疾发作，成为旅游者以及出现病情延迟，在单因素分析中，特征明确的危险因素与严重的疟疾有关。在对这些潜在的混杂因素进行调整后，高血压（调整后的优势比aOR，3.06 95％置信区间，CI 1.34-7.02），心血管疾病（aOR，8.20 95％CI 2.30-29.22）和血脂异常（aOR，6.08 95％CI 1.13- 32.88）是多变量Logistic回归中与重症相关的个别疾病。高血压被证明是地方性（aOR，4.83，95％CI 1.44-16.22）和非地方性起源（aOR，3.60 95％CI 1.05-12.35）个体的独立危险因素。
结论：在输入的恶性疟疾中，高血压及其相关疾病是严重疾病的危险因素。
