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首页> 外文期刊>Transactions of the Royal Society of Tropical Medicine and Hygiene >Spleen volume and clinical disease manifestations of severe plasmodium falciparum malaria in African children
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Spleen volume and clinical disease manifestations of severe plasmodium falciparum malaria in African children

机译：非洲儿童严重恶性疟原虫疟疾的脾脏体积和临床疾病表现

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Background: Plasmodium falciparum malaria is common in African children. Severe disease manifestations include severe malarial anemia (SMA) and cerebral malaria (CM). In vitro studies suggest that splenic sequestration is associated with SMA and protective against CM. We sought to characterize the relationship between ultrasonographically derived spleen volume (SV), clinical manifestations and outcome. Methods: We conducted a prospective observational study of severe malaria and SV in children aged 3 months to 12 years in Eastern Uganda. An SV normogram was generated from 186 healthy controls and adjusted for total body surface area (TBSA). Children with severe P. falciparum malaria were classified according to disease phenotype, and SV z-scores were compared for cases and controls to assess the degree of spleen enlargement. Results: One hundred and four children with severe malaria, median age 19.2 months, were enrolled; 54 were classified as having SMA and 15 with CM. Mortality was 27% in the CM group vs 1.9% in the SMA group. TBSA-adjusted SV z-scores were lower in children with CM compared to SMA (1.98 [95% CI 1.38-2.57] vs 2.73 [95% CI 2.41-3.04]; p=0.028). Mean SV z-scores were lower in children who died (1.20 [95% CI 0.14-2.25]) compared to survivors (2.58 [95% CI 2.35-2.81]); p=0.004. Conclusions: SV is lower in CM compared to SMA. Severe malaria with no increase in SV z-score may be associated with mortality.
机译：背景：恶性疟原虫疟疾在非洲儿童中很常见。严重的疾病表现包括严重的疟疾贫血（SMA）和脑疟疾（CM）。体外研究表明，脾隔离症与SMA有关并且对CM具有保护作用。我们试图表征超声检查得出的脾脏体积（SV），临床表现和预后之间的关系。方法：我们对乌干达东部3个月至12岁的儿童进行了严重疟疾和SV的前瞻性观察研究。 SV范数图是从186名健康对照中生成的，并针对总身体表面积（TBSA）进行了调整。根据疾病表型对患有严重恶性疟原虫疟疾的儿童进行分类，并比较SV z评分的病例和对照组，以评估脾脏肿大的程度。结果：104例重度疟疾患儿入组，中位年龄19.2个月。 54例为SMA，15例为CM。 CM组死亡率为27％，SMA组为1.9％。与SMA相比，CM儿童的TBSA调整后的SV z评分更低（1.98 [95％CI 1.38-2.57] vs 2.73 [95％CI 2.41-3.04]; p = 0.028）。与幸存者（2.58 [95％CI 2.35-2.81]）相比，死亡儿童的平均SV z得分（1.20 [95％CI 0.14-2.25]）低。 p ＝ 0.004。结论：CM的SV低于SMA。严重疟疾而SV z评分未升高可能与死亡率有关。

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