2010—2019年浙江省麻风反应及影响因素研究

Prevalence and influencing factors of leprosy reactions from 2010 to 2019 in Zhejiang Province

目的分析2010—2019年浙江省麻风反应发生情况及影响因素,为控制麻风病提供依据。方法通过全国麻风病防治管理信息系统收集2010—2019年浙江省新发麻风病病例和麻风反应资料,分析病例不同人口学特征和麻风类型的麻风反应发生率,采用多因素Logistic回归模型分析麻风反应的影响因素。结果 2010—2019年浙江省新发麻风病病例191例,麻风反应发生率为29.32%,其中Ⅰ型反应发生率为16.75%,Ⅱ型反应发生率为9.42%,混合型反应发生率为3.14%。联合化疗(MDT)开始前发生麻风反应33例,占58.93%;MDT开始后0~6个月发生麻风反应13例,占23.21%;MDT开始后7~12个月发生麻风反应5例,占8.93%;MDT开始后12个月以上发生麻风反应3例,占5.36%;MDT完成后发生麻风反应2例,占3.57%。多因素Logistic回归分析结果显示,≤35岁(OR=2.245,95%CI:1.006~5.008)、常住人口(OR=3.442,95%CI:1.394~8.494)、家庭外传染(OR=3.878,95%CI:1.075~13.993)和细菌密度指数阳性(>0+,OR=4.514,95%CI:1.365~14.926;>3+,OR=4.727,95%CI:1.443~15.485)是麻风反应的危险因素。结论 2010—2019年浙江省麻风反应发生率较高,年龄、流动人口、传染来源、细菌密度指数与麻风反应的发生有关。

Objective To analyze the prevalence and influencing factors of leprosy reactions in Zhejiang Province from2010 to 2019,so as to provide reference for the control of leprosy.Methods Through the national leprosy management system,the new leprosy cases in Zhejiang Province from 2010 to 2019 were recruited to analyze the incidence of leprosy reactions in different demographic characteristics and leprosy clinical features.The multivariate logistic regression analysis was conducted to explore the influencing factors for leprosy reactions.Results Totally 191 leprosy cases were investigated.The incidence rate of leprosy reactions was 29.32%;the the incidence rate of type Ⅰ and type Ⅱ reaction was 16.75% and 9.42%,respectively.There were 33 leprosy reaction cases(58.93%) before multidrug therapy(MDT),13 cases(23.21%) during 0-6 months of MDT,5 cases(8.93%) during 7-12 months of MDT,3 cases(5.36%) during over 12 months of MDT,and 2 cases(3.51%) after MDT.The results of the multivariate logistic analysis showed that the cases who were 35 years old or below(OR=2.245,95%CI:1.006-5.008),were not floating population(OR=3.442,95%CI:1.394-8.494),were infected outside family(OR=3.878,95%CI:1.075-13.993) and were smear positive(>0+,OR=4.514,95%CI:1365-14.926;>3+,OR=4.121,95%CI:1.443-15.485) were risk factors for leprosy reactions.Conclusions The prevalence of leprosy reactions is high in Zhejiang Province from 2010 to 2019,and is associated with age,floating population,source of infection and BI.