2005-2022年新疆喀什地区内脏利什曼病流行病学及时空分布特征

Epidemiological and spatio-temporal distribution characteristics of visceral leishmaniasis in Kashi Prefecture,Xinjiang,2005-2022

目的 分析2005-2022年新疆喀什地区内脏利什曼病(VL)的流行病学特征和时空分布情况,为指导喀什地区制定VL的防控方案提供科学依据。方法 收集国家传染病报告信息管理系统中2005-2022年新疆喀什地区VL报告病例数据,采用描述性流行病学分析VL的三间分布特征,使用Geoda 1.22软件进行空间自相关分析,使用SaTScan 10.1.2软件进行时空扫描统计分析。结果 2005-2022年新疆喀什地区共报告1 965例VL病例,年均发病率为0.13/10万人,2008年和2015年为发病高峰期,发病率分别为6.10/10万(363例)和8.29/10万(396例)。男性、女性报告病例分别为1 125和840例,男女性别比为1.34∶1;各年龄组中均有病例报告,主要分布在0~4岁年龄组(75.47%,1 483/1 965);职业分布以散居儿童最多(75.32%,1 480/1 965)。2005-2022年新疆喀什地区每月均有病例报告,其中2008-2010年和2014-2016年的季节性分布较为明显,9-12月为报告高峰。2005-2022年VL报告病例主要分布在喀什地区的北部县(市),发病率最高的4个县(市)分别为伽师县(15.84/10万)、喀什市(4.10/10万)、疏附县(1.30/10万)和巴楚县(1.21/10万)。全局空间自相关分析结果显示,2012年的发病率在空间上呈现正相关性(Moran’s I=0.126 5,Z> 1.96,P <0.05)。局部自相关分析结果显示,高-高聚集区主要分布在疏附县、喀什市、伽师县和疏勒县。时空扫描分析结果显示,主要聚集区为伽师县,聚集的高发时间段在2008-2016年。结论 2005-2022年新疆喀什地区VL总体流行呈下降趋势,高危人群以低龄散居儿童为主,北部县(市)是VL的高流行区域。

Objective To analyze the epidemiological characteristics and spatio-temporal distribution of visceral leishmaniasis(VL) in Kashi Prefecture, Xinjiang, from 2005 to 2022, to provide a scientific basis for formulating prevention and control strategies for VL in Kashi area.Methods Data on VL cases reported in Kashi Prefecture,Xinjiang, from 2005 to 2022 were collected from the National Diseases Reporting Information System. Descriptive epidemiological methods were used to analyze the three-dimensional distribution characteristics of VL. Spatial auto-correlation analysis was performed using Geoda 1.22 software, and spatio-temporal scanning statistical analysis was performed using SaTScan 10.1.2 software.Results From 2005 to 2022, a total of 1 965 VL cases were reported in Kashi Prefecture, Xinjiang, with an average annual incidence rate of 0.13 per 100 000 people. The peak incidence years were 2008and 2015, with incidence rates of 6.10 per 100 000(363 cases) and 8.29 per 100 000(396 cases), respectively. Among the population distribution characteristics, 1 125 cases were male and 840 were female, with a male-to-female ratio of1.34∶1. Cases were reported across all age groups, with the composition rate of 75.47%(1 483/1 965) in the 0-4 years age group. The high-risk population was scattered children(75.32%, 1 480/1 965). VL cases were reported monthly from 2005 to 2022, with noticeable seasonal distribution between 2008-2010 and 2014-2016, peaking from September to December. VL mainly occurred in the northern counties of Kashi, with the highest incidence rate in Jiashi County(15.84/100 000), Kashi City(4.10/100 000), Shufu County(1.30/100 000), and Bachu County(1.21/100 000). The results of spatial auto-correlation analysis revealed a significant positive spatial correlation in the incidence of VL in Kashi Prefecture, Xinjiang in 2012(Moran's I = 0.126 5, Z = 2.193 2, P < 0.05). Local autocorrelation analysis exhibited that highhigh clustering areas were mainly distributed in Shufu County, Kashgar City, Jiashi County and Shule County. Spatiotemporal scanning analysis showed that the main clustering area was Jiashi County, and a high incidence period was from2008 to 2016.Conclusion From 2005 to 2022, the overall incidence of VL exhibited a downward trend in Kashi Prefecture, Xinjiang. The high-risk population consisted mainly of young scattered children, and the northern counties of Kashi were the high endemic areas of VL.