2005-2008年新疆维吾尔自治区阿图什市内脏利什曼病的流行与防治状况

An epidemioiogical survey of visceral leishmaniasis in Artux City of Xinjiang Uygur Autonomous Region during 2005-2008

目的了解和掌握2005—2008年新疆维吾尔自治区阿图什市内脏利什曼病（VL）的流行和防治。方法通过对流行乡村居民和在校中、小学生体检（触诊肝、脾）的方法进行普查，宣传VL防治知识，并动员乡村医务人员和群众提供疑似患者和（或）死亡者的线索，对已治愈的患者进行随访。以上一年发现患者的家庭为中心，对半径50m内的住宅和畜圈内、外墙面喷洒高效氯氟氰菊酯灭蛉。结果2005--2008年VL患者共41例，其中普查14888人，查出现患病例33例，自行上门就诊者8例。2005-2008年病例数依次为15、10、6和10例。年龄在20岁以下的占80．49％（33／41），21岁以上的占19．51％（8／41）。随访41例已治疗患者，治愈康复35例，复发4例，死亡2例。通过各种宣传活动发放防治VL宣传单10000余张，张贴宣传画1000余张，中、小学发放折页画3500余张。培训患者家属及其邻里、乡村干部和中、小学教师共585人。2005--2008年348户喷洒杀虫剂，面积约9万m^2。喷洒前白蛉密度为41～70只／人工小时，喷洒后为2～21只／人工小时。结论阿图什市的VL仍然流行。白蛉季节前开展喷洒杀虫剂灭蛉和普查普治患者可减少传染源和传播媒介，降低发病率，达到控制的效果。

Objective To find out the epidemiological situation of the visceral leishmaniasis in Artux city of Xinjiang Uygur Autonomous Region from 2005 to 2008. Methods Through physical examinations （palpation on liver, spleen）, the survey was made among the villagers and the primary and middle school students, the common knowledge about control and prevention of visceral leishmaniasis was propagated. Mean-while, steps were taken to mobilize the village medical staff and villagers to provide relevant clues of the suspected patients or the dying victims. Visits were paid to cured patients. Taking the past-year patients＇ families as the centre, the anti-lambda-cyhalothrin was sprayed in a 50-meter-radius around the previous patients＇ house and corral. Results From 2005 to 2008, there were 41 visceral leishmaniasis cases in all. Among them, 33 cases had been found in 14 888 persons investigated, 8 patients went to see the doctor by themselves, the number of such cases each year were 15, 10, 6 and 10. The age below 20 years old accounted for 80.49% （33/ 41 ） , and above 21 years old accounted for 19.51% （8/41）. Among the 41 treated cases, there were 35 cases cured, 4 cases recurred and 2 cases dead. Through many kinds of promotional activities, 10 000 leaflets, 1 000 posters and 3 500 folding plates were provided in order to propagandize how to prevent visceral leishmaniasis. More than 585 persons were trained among the patients＇ families, their neighbors, the village cadres and teachers. From 2005 to 2008, insecticides were sprayed to about 90 000 m2 around 348 families. Before spraying, 41-70 sandflies could be killed per hour per one person, after spraying, only 2-21 sandflies could be killed per hour per one person. Conclusion The visceral leishmaniasis is still prevalent in Artux City. Spraying insecticides and massive investigation and treatment before the sandfly season could reduce the origin of infection and transmission vectors so as to control the disease.