2015-2018年我国内脏利什曼病疫情分析

Prevalence of visceral leishmaniasis in China during 2015-2018

目的了解2015-2018年我国内脏利什曼病疫情状况,为制定防治策略和措施提供科学依据。方法收集2015-2018年中国疾病预防控制中心传染病报告信息管理系统中内脏利什曼病报告病例信息,剔除疑似病例、重复病例以及皮肤利什曼病病例,建立数据库,采用Microsoft Excel 2016软件对内脏利什曼病报告病例的三间分布进行描述性流行病学分析。1194例,病例主要分布于新疆(669例)、甘肃(271例)和四川(79例)等3个省。其中73个县属于流行区,共报告本地感染病例1064例,其余104个县属于非流行区,共报告输入性病例130例。新疆伽师县(497例)和甘肃省舟曲县(94例)、宕昌县(49例)和武都区(71例)为主要流行县,报告病例数占全国总病例数的59.5%(711/1194)。2015-2018年,甘肃、山西、陕西和河南等4省共有9个县出现内脏利什曼病复燃,报告本地感染病例25例。内脏利什曼病患者发病高峰为10-11月,男女患者比为1∶0.7。婴幼儿和农民是我国内脏利什曼病高风险人群,分别占全部病例数的67.3%(803/1194)和18.8%(224/1194)。内脏利什曼病病例主要分布于0~2岁年龄组(727例),不同流行类型病例年龄分布明显不同,野生动物源型和人源型内脏利什曼病病例主要分布于0~2岁年龄组(557、30例),犬源型内脏利什曼病病例主要分布于≥15岁年龄组(198例)。结论我国内脏利什曼病呈低度流行态势,但流行范围逐渐扩大。

Objective To understand the prevalence of visceral leishmaniasis(VL)in China during 2015-2018,providing scientific basis for formulating strategies and measures for prevention and control.Methods Information of VL cases reported during 2015-2018 from the web-based National Diseases Reporting Information System(NDRIS)operated by the Chinese Center for Disease Control and Prevention was collected.A database was established after excluding suspected cases,duplicate cases and cutaneous leishmaniasis cases.The three-compartment distribution of VL cases was analyzed with descriptive statistics using Microsoft Excel 2016.Results During 2015-2018,a total of 1194 VL cases were reported in 177 counties(cities)of 16 provinces(autonomous regions and municipalities).They were mainly distributed in Xinjiang(669 cases),Gansu(271 cases)and Sichuan Province(79 cases).Of the 177 counties(cities),73 were endemic areas,reporting 1064 indigenous cases,while the other 104 counties(cities)were non-endemic areas,reporting 130 imported VL cases.In particular,Jiashi County(497 cases),Zhouqu county(94 cases),Dangchang county(49 cases)and Wudu district(71 cases)were major endemic regions;the number of cases reported in the 4 areas accounted for 59.5%(711/1194)of the grand total reported.During2015-2018,VL recurrence occurred in 9 counties of 4 provinces including Gansu,Shanxi,Shaanxi and Henan Provinces,where 25 indigenous cases were reported.The onset of VL peaked during October-November,with a male/female ratio of 1∶0.7.Infants and farmers were high-risk populations of VL,accounting for 67.3%(803/1194)and 18.8%(224/1194)of total cases,respectively.The VL cases were mainly distributed within ages of 0-2 years(727 cases).The age distribution of different epidemiological types of VL obviously varied.The desert-type zoonotic and anthroponotic types of VL were mainly distributed within ages of 0-2 years(557 cases and 30 cases),while the mountain-type zoonotic VL was mainly distributed at ages≥15 years(198 cases).Conclusion Visceral leishmaniasis endemic in China displays a status of low prevalence,but the endemic area shows a trend of expansion.