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Acute hemorrhagic fever: Clinical, Epidemiological and Laboratory Aspects in São Toméand Príncipe

Advances in Infectious Diseases 2022年第4期12卷 721-744页

作者： Eula Carvalho Didiena Vilhete Clara Assunção Ana Silva Jessica Vicente Ana Cristina Cleiser Vagente Francelina Costa Celdidy Monteiro Bakissi Pina Medicine Service Dr. Ayres de Menezes Hospital S&#227 o Tomé S&#227 o Tomé and Príncipe Manuel Quaresma Dias da Graç a Hospital S&#227 o Tomé S&#227 o Tomé and Príncipe Centro de Saúde de Mezochi Health Area of Mezochi S&#227 o Tomé S&#227 o Tomé and Príncipe Laboratory of Clinical Analyses Hospital Dr Ayres de Menezes S&#227 o Tomé S&#227 o Tomé and Príncipe Direction of Health Care Sector of Investigation Department of Epidemiological Surveillance S&#227 o Tomé S&#227 o Tomé and Príncipe

Background: In the last 6 months, cases of acute hemorrhagic fever (AHF) have been recorded in Sao Tome and Principe (STP). Objective: To identify the clinical, epidemiological and laboratory parameters associated with AHF cases found in patients hospitalized in STP. Methods: Descriptive and quantitative analysis of AHF cases hospitalized in STP in the period December 2021 to May 19, 2022 through the variables: demographic data;clinical data;laboratory data and clinical outcome. Results: Analyzed 18 of 22 AHF cases, 50% of them male, mean age 33.7 years, 85.7% residing in the 2 largest districts of the country, 66.7% rural workers, administrative near maritime areas, sailors and domestics. 66.7% were healthy individuals. ≥50% had a fever, asthenia/weakness, myalgia, headache, lethargy, nausea, vomiting, and diarrhea. 22.2% to 33.3% had retro-orbital pain, abdominal pain, decreased consciousness, dyspnea/hypoxia, and cough. In a smaller register (5.6% - 11.1%), exanthema, convulsion, arthralgia, low back pain, chills, and chest pain. Bleeding from the digestive tract was found in 72.2%, followed by vaginal (33.3%), urethral (27.8%), nasal (22.2%), and oral (16.7%). 50% had laboratory confirmation for dengue, and another 50% with suspected clinical diagnosis without laboratory confirmation of the etiologic agent. Despite hemorrhage, 66.7% of confirmed cases were hemodynamically non-severe, and 88.9% of suspected cases were severe. Coinfection with malaria is evidenced in 11.1% of cases. 72.2% recovered and 27.8% died (deaths in 55.5% of suspected cases). Case deaths were male (100%), resident foreigners (40%), tool store employees, sailors and students, healthy (80%), and residing in the largest district in the country (60%). All deaths were hospitalized in serious condition, 80% were hospitalized for hemorrhage and shock, with bleeding arising between day 4 - 5 of illness in 60% and hospitalization on day 5 of illness. 60% died within ≤24 hours of hospitalization. 80

关键词： Acute hemorrhagic fever viral hemorrhagic fever Dengue São Tomé and Príncipe Hospitalization Epidemic Dr. Ayres de Menezes Hospital

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