典型文献
Non-traumatic coma in young children in Benin: are viral and bacterial infections gaining ground on cerebral malaria?
文献摘要：
Background::While malaria morbidity and mortality have declined since 2000, viral central nervous system infections appear to be an important, underestimated cause of coma in malaria-endemic Eastern Africa. We aimed to describe the etiology of non-traumatic comas in young children in Benin, as well as their management and early outcomes, and to identify factors associated with death .Methods::From March to November 2018, we enrolled all HIV-negative children aged between 2 and 6 years, with a Blantyre Coma Score ≤ 2, in this prospective observational study. Children were screened for malaria severity signs and assessed using a systematic diagnostic protocol, including blood cultures, malaria diagnostics, and cerebrospinal fluid analysis using multiplex PCR. To determine factors associated with death, univariate and multivariate analyses were performed.Results::From 3244 admissions, 84 children were included: malaria was diagnosed in 78, eight of whom had a viral or bacterial co-infection. Six children had a non-malarial infection or no identified cause. The mortality rate was 29.8% (25/84), with 20 children dying in the first 24 h. Co-infected children appeared to have a poorer prognosis. Of the 76 children who consulted a healthcare professional before admission, only 5 were prescribed adequate antimalarial oral therapy. Predictors of early death were jaundice or increased bilirubin [odd ratio (
OR)= 8.6; 95% confidential interval (
CI): 2.03–36.1] and lactate > 5 mmol/L (
OR= 5.1; 95%
CI: 1.49–17.30). Antibiotic use before admission (
OR = 0.1; 95%
CI: 0.02–0.85) and vaccination against yellow fever (
OR= 0.2, 95%
CI: 0.05–0.79) protected against mortality.
Conclusions::Infections were found in all children who died, and cerebral malaria was by far the most common cause of non-traumatic coma. Missed opportunities to receive early effective antimalarial treatment were common. Other central nervous system infections must be considered in their management. Some factors that proved to be protective against early death were unexpected.
文献关键词：
Non-traumatic coma;Cerebral malaria;Co-infection;Central nervous system infection;West Africa
中图分类号：
作者姓名：
Brisset Josselin;Baki Karl Angendu;Watier Laurence;Kinkpé Elisée;Bailly Justine;Ayédadjou Linda;Alao Maroufou Jules;Dossou-Dagba Ida;Bertin Gwladys I.;Cot Michel;Boumédiène Farid;Ajzenberg Daniel;Aubouy Agnès;Houzé Sandrine;Faucher Jean-Fran?ois;NeuroCM Group
作者机构：
Infectious Diseases and Tropical Medicine Department, Limoges University Hospital, 2 Avenue Martin Luther King, 87000 Limoges, France;Inserm UMR 1094, IRD U270, EpiMaCT-Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Univ. Limoges, CHU Limoges, Limoges, France;Center for Research in Epidemiology and Population Health (CESP), INSERM U1018, Paris-Saclay University, UVSQ, Montigny-Le-Bretonneux, France;Epidemiology and Modeling of Bacterial Evasion to Antibacterials Unit (EMEA), Institut Pasteur, 25-28, Rue du Dr. Roux, 75724 Paris Cedex 15, France;Paediatric Department, Calavi Hospital, Calavi, Benin;UMR261 MERIT, IRD, Université de Paris, 75006 Paris, France;French Malaria Reference Center, H?pital Bichat, APHP, Paris, France;Paediatric Department, Mother and Child University and Hospital Center (CHU-MEL), Cotonou, Benin;Clinical Research Institute of Benin (IRCB), Abomey Calavi, Benin;UMR152 PHARMADEV, Université de Toulouse, IRD, UPS, Toulouse, France;Parasitology Laboratory, Hopital Bichat-Claude-Bernard, APHP, Paris, France
文献出处：
引用格式：
[1]Brisset Josselin;Baki Karl Angendu;Watier Laurence;Kinkpé Elisée;Bailly Justine;Ayédadjou Linda;Alao Maroufou Jules;Dossou-Dagba Ida;Bertin Gwladys I.;Cot Michel;Boumédiène Farid;Ajzenberg Daniel;Aubouy Agnès;Houzé Sandrine;Faucher Jean-Fran?ois;NeuroCM Group-.Non-traumatic coma in young children in Benin: are viral and bacterial infections gaining ground on cerebral malaria?)[J].贫困所致传染病（英文）,2022(02):1-10
A类：
comas,Blantyre,Missed
B类：
Non,traumatic,young,children,Benin,viral,bacterial,infections,gaining,cerebral,Background,While,morbidity,mortality,have,declined,since,central,nervous,important,underestimated,cause,endemic,Eastern,Africa,aimed,describe,etiology,well,their,management,early,outcomes,identify,factors,associated,death,Methods,From,March,November,enrolled,all,HIV,negative,aged,between,years,Coma,Score,this,prospective,observational,study,Children,were,screened,severity,signs,assessed,using,systematic,protocol,including,blood,cultures,diagnostics,cerebrospinal,fluid,analysis,multiplex,To,determine,univariate,multivariate,analyses,performed,Results,admissions,included,was,diagnosed,eight,whom,had,Six,identified,rate,dying,first,infected,appeared,poorer,prognosis,Of,consulted,healthcare,professional,before,only,prescribed,adequate,antimalarial,oral,therapy,Predictors,jaundice,increased,bilirubin,odd,ratio,confidential,interval,lactate,Antibiotic,vaccination,against,yellow,fever,protected,Conclusions,Infections,found,died,by,far,most,common,opportunities,receive,effective,treatment,Other,must,considered,Some,that,proved,protective,unexpected,Cerebral,Central,West
AB值：
0.532814
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