我国输入性疟疾患者回国后就医时机及其影响因素的系统评价  

Systematic review of the timing of medical consultation and influencing factors for imported malaria patients returning to China

作　　者：顾己悦 柴丽莹 曹园园[2] 崇泽银 刘凯旋 王伟明[2] 徐玉慧 朱国鼎[2] 曹俊[2] 卢光玉 GU Ji-yue;CHAI Li-ying;CAO Yuan-yuan;CHONG Ze-yin;LIU Kai-xuan;WANG Wei-ming;XU Yu-hui;ZHU Guo-ding;CAO Jun;LU Guang-yu(School of Public Health,Yangzhou University,Yangzhou,Jiangsu 225009,China;不详)

机构地区：[1]扬州大学公共卫生学院,江苏扬州225009 [2]国家卫生健康委员会寄生虫病预防和控制技术重点实验室,江苏省寄生虫与媒介控制技术重点实验室,江苏省血吸虫病防治研究所 [3]扬州市疾病预防控制中心 [4]江苏省人兽共患病学重点实验室,江苏扬州225009

出　　处：《现代预防医学》2024年第17期3223-3230,共8页Modern Preventive Medicine

基　　金：国家自然科学基金(72374178,71904165);国家卫生健康委员会寄生虫病预防与控制技术重点实验室、江苏省寄生虫与媒介控制技术重点实验室开放课题(wk023-007);江苏省人兽共患病学重点实验室资助项目(R2208);江苏省高校动物重要疫病和重要人兽共患病防控技术国际合作联合实验室(01)。

摘　　要：目的总结我国输入性疟疾患者出现首发症状到初次就诊时间间隔及其影响因素,为优化输入性疟疾患者的健康管理和防控措施,巩固我国疟疾消除成果提供参考。方法通过系统性地检索PubMed、EBSCO、中国知网(CNKI)、万方和维普等中英文数据库以及相关研究的参考文献,收集报告了我国输入性疟疾患者出现首发症状到初次就诊时间间隔和(或)影响因素的研究,检索时间自建库到2023年7月18日。两名研究者根据纳入排除标准独立对获取的文献进行筛选并提取信息。采取适用于横断面研究的纽卡斯尔-渥太华量表(NOS)对纳入研究进行质量评价。结果共纳入17篇研究报告的10475例输入性疟疾患者的就医时机或其影响因素,其中8篇研究报告了2919例输入性疟疾患者出现首发症状到初次就医的时间间隔。766例(26.24%)在出现首发症状1 d内就诊,1393例(47.72%)在出现首发症状后第2~3 d内就诊,760例(26.04%)在出现首发症状3 d后才初次就诊。11篇研究报告了我国输入性疟疾患者就医时机的影响因素,包括输入性疟疾患者的主动就医的意识、初诊医疗机构的级别、疟疾感染史、行为素养、感染疟原虫的类型及潜伏期等。结论我国输入性疟疾患者回国后存在一定的就医延误。其中,主动就医的意识较弱、行为素养较差、感染间日疟原虫、初诊医疗机构级别较高等输入性疟疾患者人群容易出现就医延迟的现象。Objective To summarize the time interval from the onset of initial symptoms to the first medical consultation for imported malaria patients in China and the influencing factors,providing references for optimizing health management and prevention measures for these patients and reinforcing malaria elimination achievements in the country.Methods A systematic search was conducted across English and Chinese databases,including PubMed,EBSCO,China National Knowledge Infrastructure(CNKI),Wanfang,and Weipu,as well as references from related studies,to collect research reporting the time interval from the onset of initial symptoms to the first medical consultation and/or influencing factors for imported malaria patients in China,with the search period extending from the establishment of the database to July 18,2023.Two researchers independently screened the literature and extracted information based on inclusion and exclusion criteria.The Newcastle-Ottawa Scale(NOS)suitable for cross-sectional studies was employed to assess the quality of the included studies.Results A total of 17 studies involving 10475 imported malaria patients were included,with 8 studies reporting the time interval from the onset of initial symptoms to the first consultation for 2919 patients.Among them,766 patients(26.24%)consulted within one day of symptom onset,1393 patients(47.72%)consulted within 2-3 days,and 760 patients(26.04%)consulted more than three days after symptom onset.Eleven studies reported the influencing factors for the timing of medical consultation among imported malaria patients in China,including the patients’awareness of the need for proactive medical consultation,the level of the initial healthcare facility,history of malaria infection,health literacy,the type of malaria parasite,and the incubation period.Conclusion There is a notable delay in medical consultation among imported malaria patients returning to China.Factors such as weak awareness of the need for proactive consultation,poor health literacy,infection with Plasmo

关 键 词：输入性疟疾 就医时机 影响因素 系统评价 

分 类 号：R531.3[医药卫生—内科学] R184.6[医药卫生—临床医学]