云南省文山州麻风高流行区新登记患者变化分析

Historical comparisons on related features among newly registered leprosy patients in the endemic areas of Wenshan district, Yunnan province

目的分析比较云南省文山州麻风流行动态及探讨流行原因。方法依据当地上报1989、1999和2009年上半年3个时点麻风流行数据资料进行分析。结果1989、1999和2009年上半年各阶段新登记病例数无明显变化，平均发现年龄33～35岁。疾病平均延迟期从1989年的35．2个月缩短到2009年的15．9个月，但在12个月以上者仍约占50％。2级畸残患者占15．2％～17．7％。麻风儿童患者比例从1989年的8．1％上升到2009年的13．1％。“门诊发现”仍然是主要的发现方式，1999和2009年主动发现的病例数分别占44．3％和42．6％，均高于1989年的17．7％。结论云南省文山州麻风流行没有明显好转，持续高流行的原因仍然是传染源未得到有效控制。

Objective To analyze the current situation and prevalence of leprosy in Wenshan district, Yunnan province. Methods To collect various data on leprosy reported by the health workers at the county level. Results The number of newly registered patients did not decrease significantly in 1989, 1999 and 2009, respectively. The mean age of patients at detection was 33-35 years old. Time of delay between the disease onset and being diagnosed was shortened from 35.2 months in 1989 to 15.9 months in 2009. However, the proportion of patients with more than 12 months of delay still accounted for nearly 50%. The proportion of Grade II disability fluctuated between 15.2%-17.7% and the proportion of child cases increased from 8.1% in 1989 to 13.1% in 2009. Clinics for skin diseases were the main locations for case detection. The proportion of new cases detected through ＇active case finding＇ program accounted for 44.3% in 1999 and 42.6% in 2009, both higher than 17.7% in 1989. Conclusion The situation of leprosy in Wenshan district, Yunnan province, was still serious and the reason for the occurrence of new cases was related to the fact that the infectious source of leprosy had not been under full control.