Postinjury Malaria: A Study of Trauma Victims in Cambodia
| Autor: | Hans Husum, Mads Sundet, Tove Heger |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Warfare medicine.medical_specialty Blood transfusion Endemic Diseases medicine.medical_treatment Wounds Penetrating Critical Care and Intensive Care Medicine Immunocompromised Host Postoperative Complications Blast Injuries Risk Factors parasitic diseases Epidemiology medicine Humans Risk factor Child Retrospective Studies business.industry Incidence Incidence (epidemiology) medicine.disease Malaria Surgery ROC Curve Emergency medicine Chemoprophylaxis Injury Severity Score Female Wounds Gunshot Cambodia business Trauma surgery |
| Zdroj: | Journal of Trauma and Acute Care Surgery. 52:259-266 |
| ISSN: | 0022-5282 |
| DOI: | 10.1097/00005373-200202000-00010 |
| Popis: | Background: The pattern of host defense against plasmodium is comparable to the immune response to bacterial infection. Posttraumatic immunosuppression may therefore cause relapses of malaria secondary to trauma and trauma surgery in asymptomatic carriers of the parasites in endemic areas. To our knowledge this has not been validated in epidemiologic studies. Methods: Postinjury malaria was registered retrospectively in 342 land mine and war victims from malaria-endemic areas in Cambodia. The incidence rate was analyzed in terms of age, gender, preinjury endemicity, evacuation times, anatomic injury severity, systolic blood pressure at admission, blood transfusion, and duration of the first surgical intervention as independent variables. Results: The rate of postinjury malaria in the study patients was 33.3% (95% CI, 28.3-38.3%). Injury Severity Score (ISS) and surgical operation time were risk factors (area under the curve in receiver operating characteristic plots were 0.73 and 0.79, respectively). The impact of the other risk factors was nonsignificant. Conclusion: Despite difficulties in diagnosing postoperative malaria in endemic areas, the study demonstrates that the rate of postinjury malaria is high. The results legitimate controlled trials of immediate postinjury chemoprophylaxis to severely injured in endemic areas. The authors recommend staged surgical operations with brief primary interventions in victims with severe injuries. |
| Databáze: | OpenAIRE |
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