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首页> 美国卫生研究院文献>Frontiers in Public Health >Caseload and Case Fatality of Lassa Fever in Nigeria 2001–2018: A Specialist Centers Experience and Its Implications
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Caseload and Case Fatality of Lassa Fever in Nigeria 2001–2018: A Specialist Centers Experience and Its Implications

机译：2001-2018年尼日利亚拉萨热的病案和病死率：专科中心的经验及其启示

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>Background: The general lack of comprehensive data on the trends of Lassa fever (LF) outbreaks contrasts with its widespread occurrence in West Africa and is an important constraint in the design of effective control measures. We reviewed the contribution of LF to admissions and mortality among hospitalized patients from 2001 to 2018 in the bid to address this gap.>Methods: Observational study of LF caseload and mortality from 2001 to 18 in terms of the contribution of confirmed LF to admissions and deaths, and case fatality (CF) among patients with confirmed LF at a specialist center in Nigeria. The diagnosis of LF was confirmed using reverse transcription polymerase chain reaction (RT-PCR) test, and medians and frequencies were compared using Kruskal-Wallis, Mann-Whitney and χ2 tests, with p-values <0.05 taken as significant.>Results: The contribution of confirmed LF to deaths (362/9057, 4.0%) was significantly higher than to admissions (1,298/185,707, 0.7%; OR [95% CI] = 5.9 [5.3, 6.7], p < 0.001). The average CF among patients with confirmed LF declined from 154/355 (43%) in 2001–09 to 183/867 (21.1%) (OR [95% CI] = 2.9 [2.2, 3.7], p < 0.001) in 2011–18. The annual CF declined from 94% in 2001 to 15% in 2018 whereas the caseload increased from 0.3 to 3.4%. The outbreaks were characterized by irregular cycles of high caseload in 2005–2007, 2012–2014, and 2016–2018, and progressive blurring of the seasonality.>Conclusion: LF outbreaks in Nigeria have upgraded spatially and temporally, with the potential for cycles of increasing severity. The strategic establishment of LF surveillance and clinical case management centers could be a pragmatic and cost-effective approach to mitigating the outbreaks, particularly in reducing the associated CF. Urgent efforts are needed in reinvigorating extant control measures while the search for sustainable solutions continues.
机译：>背景：普遍缺乏关于拉萨热（LF）爆发趋势的全面数据，这与在西非广泛流行形成鲜明对比，这是设计有效控制措施的重要限制。为了弥补这一差距，我们回顾了2001年至2018年LF对住院患者入院率和死亡率的贡献。>方法：就2001年至18日的LF病例数和死亡率进行的观察性研究尼日利亚专科中心确诊LF的确诊LF对入院和死亡的影响以及病死率（CF）。 LF的诊断通过逆转录聚合酶链反应（RT-PCR）检验得到证实，中位数和频率通过Kruskal-Wallis，Mann-Whitney和χ2检验进行比较，p值<0.05为显着。>结果：确认的LF对死亡的贡献（362/9057，4.0％）显着高于入院率（1,298 / 185,707，0.7％; OR [95％CI] = 5.9 [5.3，6.7]，p <0.001）。 2011-09年确诊为LF的患者的平均CF从154/355（43％）降至183/867（21.1％）（OR [95％CI] = 2.9 [2.2，3.7]，p <0.001） –18。每年的现金流从2001年的94％下降到2018年的15％，而案件数量从0.3％增加到3.4％。爆发的特点是2005-2007年，2012-2014年和2016-2018年的高病例数不规则周期，以及季节性的逐渐模糊。>结论：尼日利亚的LF爆发在空间和时间上都得到了改善，可能会导致严重性增加。 LF监视和临床病例管理中心的战略性建立可以是一种务实且具有成本效益的方法，可以减轻疫情的爆发，特别是在减少相关CF方面。在继续寻求可持续解决方案的同时，需要采取紧急措施重振现有控制措施。

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