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在中非恶性疟高度流行区对疟疾发作的诊断是困难的,尤其自从广泛应用抗疟药及感染人群出现抗药性现象以来更是如此。在农村和城市的一些地区,在校儿童3/4以上为带虫者,血检阳性并不意味疟疾发作;而真正的发作,即使是重型,可能因感染红细胞滞留于内脏毛细血管内而致外周血液中不出现疟原虫,所以阴性结果也并非无疟疾发作。就诊断而言,虫荷概念是重要的,但对年龄、免疫水平、近期是否用过抗疟药以及抗药性等因素均应考虑。
The diagnosis of malaria episodes is difficult in the highly endemic area of falciparum malaria in Central Africa, particularly since the widespread use of antimalarial drugs and the emergence of resistance in infected populations. In rural areas and in some parts of the city, more than 3/4 of the children in school are infected with worms. A positive blood test does not mean malaria. A real attack, even heavy, may result from the retention of red blood cells in visceral capillaries Plasmodium does not appear in peripheral blood, so the negative result is not without a malaria episode. In terms of diagnosis, the concept of insect burden is important, but factors such as age, immunization level, recent use of antimalarial drugs and resistance should be considered.