1985-2009年四川省非疫区流动人口黑热病发病分析

Incidence of Leishmaniasis in Floating Population in Non-endemic Areas of Sichuan,1985-2009

目的分析非疫区流动人口黑热病发病趋势,为制定防治对策与临床减少病例误诊和复发提供依据。方法收集、整理四川省1985-2009年黑热病疫情报告、各级医疗机构诊治病例的病历记录资料;对就诊病例采用病原学或免疫学检测,阳性者给予锑剂治疗和收集流行病学资料。结果 1985-2009年四川省共检出非疫区流动人口黑热病293例,检出的病例均有流行季节黑热病疫区居留史,居留时间3 d～10年。全年各月均有发病,以到九寨沟、汶川、黑水县和甘肃、新疆疫区后获得感染的居多,分别占31.06%、17.75%、7.51%、19.80%和15.36%。发病以男性居多,年龄以20～50岁中青年为主,占77.82%。发病到确诊时间为7 d～2年。改传统锑剂剂量为按公斤体重增大锑剂用量,复发率由17.05%降为6.83%。2005年以来,流动人口发病呈回升趋势。结论四川省非疫区流动人群黑热病发病人数近年呈上升趋势,应引起有关部门的高度重视。

Objective To analyze the incidence trend of leishmaniasis in floating population in non-endemic areas of Sichuan,provide evidence for the prevention and control strategies and the reduction of clinical misdiagnosis and recurrence.MethodsThe epidemic reports and patients＇ records were collected from the medical institutions of Sichuan.The etiological or immunological examinations were performed for suspected cases.The positive person was given sodium stibogluconate treatment and their epidemiological history was inquired.ResultsA total of 293 leishmaniasis cases were detected in floating population in non-endemic areas of Sichuan from 1985 to 2009.All patients had the history of living in endemic area of leishmaniasis during transmission season,and the length of their stay in endemic area ranged from 3 days to 10 years.The cases occurred all the year round,and most cases occurred after return from endemic area in Jiuzhaigou,Wenchuan,Heishui counties and Gansu,Xinjiang provinces,accounting for 31.06%,17.75%,7.51%,19.80% and 15.36% respectively.Most cases were males aged from 20 to 50 years,accounting for 77.82%.The intervals between onset and diagnosis were from 7 days to 2 years.After the increase of sodium stibogluconate dosage based on the patients＇ body weight,the recurrence rate dropped to 6.83% from 17.05%.However,the incidence of leishmaniasis in floating population increased again after 2005.ConclusionIt is necessary to pay close attention to the recent rising of leishmaniasis incidence in floating population in non-endemic areas of Sichuan.