甘肃省1949-2012年麻风流行病学特征与防治情况分析

An Epidemiology Survey of Leprosy and Prevention Situation of Gansu Province in 1949-2012

目的分析甘肃省1949-2012年麻风流行特征及防治策略的变迁情况及防治效果,为完善及调整本省麻风防治策略提供参考依据。方法回顾性分析调查,计算麻风发病率、发现率、患病率、儿童麻风构成比等指标,分析甘肃省近60多年麻风防治效果及流行趋势变化。结果 1949-2012年甘肃省累计发现麻风患者4 883例,治愈3 634例(74.42%);复发312例(8.59%),其中DDS单疗复发98.40%(307/312)、MDT复发1.60%(5/312);至2012年底,发病率、发现率和患病率均大幅下降,降幅分别为99.56%,99.38%和99.30%;儿童麻风构成比由防治初期50年代的12.35%降至2000-2012年的3.88%,逐年下降差异有统计学意义(P<0.001);Ⅱ级畸残率年均36.27%;平均病期4.25年。结论麻风流行已得到有效控制,目前处于极低流行状态,由于其潜伏期长、发病隐匿致病例发现滞后等因素,彻底消除麻风仍需要一个漫长的过程。

Objective To analyze characteristics of leprosy epidemic and changes of the control strategy and efficiency from 1949 to 2012 in Gansu province , provide the evidence basis for improving and adjusting strategies of leprosy prevention. Methods Leprosy control efficiency and epidemic trends of Gansu province nearly 60 years was retrospectively analyzed using the data of leprosy incidence, discovery rate, morbidity and constituent ratio of children leprosy and so on. Results From 1949 to 2012, a total of 4 883 cases of leprosy patients were identified, including 3634 （74.42%） cure, 312 cases （8. 59% ） recurrence, among which 98.40% （307/312） recurrence was treated by DDS and 1.60% （5/312） treated by MDT. By the end of 2012, the incidence, discovery rate and morbidity rates have dropped dramatically with 99. 56%, 99.38% and 99. 30% respectively; Leprosy constitute ratio of children significantly decreased from 12.51% in 1950s to 3.88% in 2000 -2012 （χ2 = 25.70 ,P 〈 0. 001 ）. Level Ⅱdisability rate was 36.27% per year, and average disease period was 4. 25 years. Conclusion Leprosy epidemic has been under effective control, currently is in a state of extremely low popularity. Because of its long incubation, concealed pathogenesis and so on, a long process is still needed to eliminate leprosy.