Prevalence of Lassa Virus Disease (LVD) in Nigerian children with fever or fever and convulsions in an endemic area

被引：33

作者：

Akhuemokhan, Odigie C. ^{[1
]}

Ewah-Odiase, Rosemary O. ^{[1
]}

Akpede, Nosa ^{[2
]}

Ehimuan, Jacqueline ^{[2
]}

Adomeh, Donatus I. ^{[2
]}

Odia, Ikpomwonsa ^{[2
]}

Olomu, Sylvia C. ^{[1
]}

Pahlmann, Meike ^{[3
]}

Becker-Ziaja, Beate ^{[3
]}

Happi, Christian T. ^{[4
]}

Asogun, Danny A. ^{[2
]}

Okogbenin, Sylvanus A. ^{[5
]}

Okokhere, Peter O. ^{[6
]}

Dawodu, Osagie S. ^{[1
]}

Omoike, Irekpono U. ^{[1
]}

Sabeti, Pardis C. ^{[7
]}

Guenther, Stephan ^{[3
]}

Akpede, George O. ^{[8
]}

机构：

[1] Irrua Specialist Teaching Hosp, Dept Paediat, Irrua, Edo State, Nigeria

[2] Irrua Specialist Teaching Hosp, Inst Lassa Fever Res & Control, Irrua, Edo State, Nigeria

[3] WHO, Bernhard Nocht Inst Trop Med, Dept Virol, Bernhard Nocht Str 74, Hamburg, Germany

[4] Univ Ibadan, Malaria Res Lab, Coll Med, Ibadan, Oyo State, Nigeria

[5] Irrua Specialist Teaching Hosp, Dept Obstet & Gynaecol, Irrua, Edo State, Nigeria

[6] Irrua Specialist Teaching Hosp, Dept Med, Irrua, Edo State, Nigeria

[7] Harvard Univ, Broad Inst, Dept Organism Biol, Cambridge, MA 02138 USA

[8] Ambrose Alli Univ, Coll Med, Fac Clin Sci, Dept Paediat, Ekpoma, Edo State, Nigeria

来源：

PLOS NEGLECTED TROPICAL DISEASES | 2017年 / 11卷 / 07期

关键词：

BACTERIAL-MENINGITIS; LUMBAR PUNCTURE; KENYAN CHILDREN; EMERGENCY-ROOM; YOUNG-CHILDREN; UNKNOWN ORIGIN; FEBRILE; DIAGNOSIS; MALARIA; ENCEPHALOPATHY;

D O I：

10.1371/journal.pntd.0005711

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background Convulsions with fever in children are a common neurologic emergency in the tropics, and determining the contribution of endemic viral infections can be challenging. In particular, there is a dearth of data on the prevalence and clinical differentiation of Lassa virus disease (LVD) in febrile children in endemic areas of Nigeria, which has multiple lineages of the virus. The aim of this study was to determine the prevalence and presentation of LVD in febrile children with and without convulsions. Methodology/Principal findings This was a prospective study of consecutive febrile children aged >= 1 month-15 years admitted to the Children's Emergency Room of Irrua Specialist Teaching Hospital over a period of 1 year. Febrile children with convulsions (Cases) were compared with those without convulsions (Controls). LVD was defined by the presence of a positive Lassa virus RT-PCR test. Rates were compared between groups using chi 2 or Fisher's exact tests and p <0.05 taken as significant. 373 (40.9%) of 913 admissions had fever. Of these, 108/373 (29%) presented with convulsions. The overall prevalence of LVD was 13/373 (3.5%; 95% CI = 1.9%, 5.7%) in febrile admissions, 3/108 (2.8%) in Cases and 10/265 (3.8%) in Controls [(Odds Ratio (95% Confidence Interval) (OR (95% CI)) of LVD in Cases versus Controls = 0.73 (0.2, 2.7)]. Only vomiting (OR (95% CI) = 0.09 (0.01, 0.70)) and bleeding (OR (95% CI) = 39.56 (8.52, 183.7)) were significantly associated with an increased prevalence of LVD. Conclusions/Significance LVD is an important cause of fever, including undifferentiated fever in children in endemic areas, but it is not significantly associated with convulsions associated with fever. Its prevalence, and lack of clinical differentiation on presentation, underscores the importance of a high index of suspicion in diagnosis. Screening of febrile children with undifferentiated fever in endemic areas for LVD could be an important medical and public health control measure.

引用

页数：17

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