Kırım Kongo Kanamalı Ateşi Virüsünün Tokat/Türkiye’de PCR Tanısı, Epidemiyolojik ve Klinik Verileri

Öz

Amaç: Tokat ilinde kene ısırığı ile sağlık kuruluşlarına başvuran hastaların klinik semptomları, laboratuvar verileri, risk faktörleri ve mortalite hızlarını değerlendirerek vaka yönetimi algoritmalarına ve kılavuzlarına katkıda bulunmaktır. Yöntem: 141 hastanın kanında konvansiyonel PCR ile virus tayini yapılmıştır. Sosyodemografik değişkenler ve risk faktörleri gibi epidemiyolojik veriler, klinik semptomlar, biyokimyasal ve hematolojik parametreler ile karşılaştırıldı. Bulgular: Hastaların 83’ü (%58,9) erkek ve 84’ü (%59,6) pozitifti. PCR pozitif grupta beş hasta (%5.95) öldü. Ateş ve kene temas öyküsü oranları PCR pozitif hastalarda PCR negatif gruba göre anlamlı olarak yüksek bulundu. Trombositopeni, lökopeni, aspartat transaminaz (AST) yüksekliği PCR pozitif hastalarda anlamlı olarak yüksek bulundu. Ortalama alanin transferaz (ALT) anlamlı olarak yüksek olmamasına rağmen, referans aralığı aşan hasta sayısındaki artış, PCR pozitif grupta anlamlı olarak yüksek bulundu (p<0.05). Sonuç: PCR tanısı, endemik bölgede öyküsü ve risk faktörleri, klinik semptomları ve uyumlu hematolojik ve biyokimyasal parametreleri olan olguların inkübasyon ve prehemorajik dönem tanısında etkin bir role sahiptir. ALT ve AST yükselmesinin vaka yönetimi algoritmasındaki yeri daha iyi aydınlatılmalıdır. Sağlık hizmetlerinin kalitesi ve iyi işleyen bir sürveyans sistemi sağlanarak hastalığa bağlı ölüm oranları azaltılabilir. Kırsal kesimde yaşayan insanların hastalık hakkındaki bilgilerinin artırılmasına yönelik çalışmalar hastalığın kontrol altına alınmasında etkili olabilir.

Anahtar Kelimeler

• PCR Teşhisi
• Kırım-Kongo Kanamalı Ateşi
• Epidemiyolojik ve Klinik Veriler

Proje Numarası

Project No: 2007-3

PCR Diagnosis, Epidemiological and Clinical Data of Crimean-Congo Hemorrhagic Fever Virüs in Tokat/Türkiye

Öz

Objectives: To contribute to case management algorithms and guidelines by evaluating the clinical symptoms, laboratory data, risk factors and mortality rates of patients admitted to health institutions with tick bite in Tokat. Methods: The virus determination was made from the blood by conventional PCR in 141 patient. Epidemiological data such as socio-demographic variables and risk factors were compared with clinical symptoms, biochemical and hematological parameters. Results: Of the patients, 83 (58.9%) were male, 84(59.6%) were positive. Five patients (5.95%) died in the PCR-positive group. Fever and tick contact history rates was found to be significantly higher in the PCR positive patients than the PCR negative group. Thrombocytopenia, leukopenia, aspartate transaminase (AST) elevation were found to be significantly higher in PCR positive patients. Despite the mean alanine transferase (ALT) was not significantly higher, the increase in the number of patients exceeding the reference range was found to be significantly higher in PCR-positive group (p<0.05). Conclusion: PCR diagnosis has an active role in the incubation and prehemorrhagic period diagnosis of cases with a history and risk factors, clinical symptoms and compatible hematological and biochemical parameters in the endemic region. The place of ALT and AST elevation in the case management algorithm should be better clarified. Mortality rates of the disease can be reduced by providing the health services quality and a well-functioning surveillance system. Efforts to increase the knowledges of people living in rural areas about the disease may be effective in controlling the disease.

Anahtar Kelimeler

• PCR diagnosis
• Crimean-Congo hemorrhagic fever
• Epidemiological and Clinical Data

Destekleyen Kurum

Gaziosmanpaşa University Scientific Research Projects Commission

Proje Numarası

Project No: 2007-3

Teşekkür

Thanks to Gaziosmanpaşa University Scientific Research Projects Commission for this research.

Kaynakça

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