2019年我国内脏利什曼病疫情分析

Prevalence of visceral leishmaniasis in China in 2019

目的了解2019年全国内脏利什曼病的疫情状况。方法收集2019年国家传染病报告信息管理系统中全国内脏利什曼病病例信息,剔除报告的疑似病例、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进行描述性流行病学分析。结果2019年全国15个省(自治区)的72个县共报告内脏利什曼病166例,其中犬源型病例163例,野生动物源型病例3例,无人源型病例。病例主要分布于山西(52例)、甘肃(43例)和陕西(34例)等3个省,合计报告病例数占全国总报告病例数的77.7%(129/166)。其中31个县属于流行区,共报告本地感染病例124例,其余41个县属于非流行区,共报告输入性病例42例。其中甘肃省舟曲县(16例)、陕西韩城市(16例)、山西阳泉市郊区(13例)和平定县(10例)为主要流行县,报告病例数占全国总报告病例数的33.1%(55/166)。甘肃省镇原县、山西省河津市、河南省龙安区、河北省邢台县为内脏利什曼病复燃流行县,共报告本地感染病例6例。内脏利什曼病发病高峰为4月份,男、女病例数分别为114、 52例,性别比为1∶0.5。农民和学龄前儿童为我国内脏利什曼病高风险人群,报告病例数分别占总报告病例数的47.6%(79/166)和27.1%(45/166)。内脏利什曼病病例主要分布于≥15岁年龄组(占85.7%),不同流行类型病例的年龄分布明显不同,野生动物源型病例均见于0~2岁学龄前儿童(3例),犬源型病例主要见于≥15岁农民。结论我国内脏利什曼病呈低流行态势,但流行区范围逐渐扩大,应加强内脏利什曼病监测。

Objective To understand the epidemic situation of visceral leishmaniasis in China in 2019.Methods Data of visceral leishmaniasis in 2019 were collected from the web-based National Diseases Reporting Information System operated by the Chinese Center for Disease Control and Prevention.After excluding suspected cases,duplicates and cutaneous leishmaniasis cases,a database was established.Descriptive epidemic statistics of visceral leishmaniasis was performed using a Microsoft Excel 2016.Results A total of 166 cases of visceral leishmaniasis were reported in 72 counties of 15 provinces(autonomous regions and municipalities)in 2019,including 163 cases of mountainous zoonotic type,3 cases of desert zoonotic type and no anthroponotic type.The cases mainly distributed in Shanxi(52 cases),Gansu(43 cases)and Shaanxi Provinces(34 cases),accounting for77.7%(129/166)of the total reported.A total of 124 local transmitted cases were reported from 31 endemic counties,and 42 imported cases reported 41 non-endemic counties.Zhouqu County of Gansu Province,Hancheng City of Shaanxi Province,Yangquan City suburb and Pingding County of Shanxi Province were the major endemic areas,with 16,16,13 and 10 cases reported respectively,accounting for 33.1%(55/166)of the total cases.Zhenyuan County in Gansu Province,Hejin City in Shanxi Province,Long’an District in Henan Province,and Xingtai County in Hebei Province were reemerging endemic counties of visceral leishmaniasis,reporting 6 indigenous cases.The occurrence of visceral leishmaniasis peaked in April,with a male-to-female ratio of 1∶0.5.Farmers as well as preschoolers are the high-risk populations for visceral leishmaniasis,accounting for 47.6%(79/166)and27.1%(45/166)of the total cases,respectively.The visceral leishmaniasis cases were mainly distributed in the group aged≥15 years.However,the age distribution varied significantly due to different types of visceral leishmaniasis,with the desert-type zoonotic cases mainly distributed in age group of 0-2 years of preschoolers and the mountain-type zoonotic cases mainly in farmers aged of≥15 years.Conclusion Visceral leishmaniasis has a low prevalence in China,whereas the endemic area shows a trend of spreading,thus,it is imperative to strengthen the surveillance for visceral leishmaniasis.