2000—2012年清远市新发麻风病例流行病学分析

Epidemiological analysis of new leprosy cases in Qingyuan City from 2000-2012

目的了解清远市麻风病的流行特征,为制定麻风病预防控制措施与方法提供科学依据。方法对2000—2012年清远市新发麻风病病例数据采用描述流行病学方法进行综合分析。结果 2000—2012年清远市共新发现麻风病患者26例,年平均发现率为0.05/10万,年平均患病率为0.15/10万,发现率和患病率总体呈下降趋势,并保持较低水平。病例发现以皮肤科门诊发现为主(92.31%)。标化平均发现率最高是连南和清新县,均为0.09/10万。26例患者中,男女性别发病无统计学差异;无儿童病例,最小发病年龄为18岁,最大为76岁,平均为52岁,病例主要集中在40岁左右年龄,年龄组发现率随年龄增长呈上升趋势。病例早期(≤24个月)年均发现比率为69.23%,发病至确诊平均时间为22个月,早期发现的病例其Ⅱ级畸残率(16.67%)明显低于延期2年以上的畸残率(25.00%)。结论清远市麻风病疫情得到有效控制并处于低流行状态。皮肤科门诊接诊是麻风病发现的主要途径。今后预防控制工作重点要以40岁左右的农村人口为重点人群,加强对该人群麻风病核心知识的宣传教育和筛查工作,加强对皮肤科医生麻风病诊断知识的培训,提高早期发现能力,及时治疗患者,减少传染性,降低畸残率。

[ Objective ] To understand the epidemiological features of leprosy in urban Qingyuan, and provide scientific basis for the formulation of leprosy prevention and control measures and methods. [ Methods] Descriptive epidemiology was used to comprehensively analyze the data of leprosy cases in urban Qingyuan from 2000-2012. [ Results] From 2000-2012, 26 cases of leprosy were found in urban, with the average annual discovery rate of 0.05/100 000 and the average annual prevalence of 0.15/100 00. The discovery rate and prevalence rate showed overall downward trend, and maintained at a relatively low level. Cases （92.31% ）were found mainly in dermatology clinic. The standardized average detection rate was highest in Liannan County and Qingyuan county, which were both O. 09/100 000. Of 26 patients, no significantly different incidence was observed between genders, no children, the minimum age of patients was 18 years old, the oldest was 76 years old, with an average of 52 years. Cases were mainly concentrated in 40 years age group, the discovery rate increased significantly with rising age. The annual discovery rate of cases early （diagnosis delay ≤24 months ） was 69.23% , the average delay of onset to diagnosis was 22 months, the disability rate of early discovered cases with grade Ⅱdisability （ 16.67% ） was significantly lower than that of cases with delay for 2 years （25.00% ）. [ Conclusion]The epidemic of leprosy has been effectively controlled in urban Qingyuan City, and maintains a low prevalence state. The outpatient department of dermatology is the main way to find leprosy cases. Prevention and control should focus on 40 years old people in rural area in future, to strengthen the leprosy core knowledge publicity and education and screening, to enhance the knowledge training of leprosy diagnosis among dermatologists, tO improve early detection capabilities, to timely treat patients,and reduce the infectiousness and deformities rate.