2019-2022年甘肃省麻风病症状监测分析

Symptom surveillance for leprosy in Gansu,2019−2022

目的分析2019-2022年甘肃省麻风病症状监测情况,为进一步优化甘肃省麻风病症状监测系统提供科学依据。方法采用横断面调查的方法,收集整理2019-2022年全国麻风病防治管理信息系统症状监测就诊的患者信息,并对流行病学特征进行分析。结果截至2022年底,全省症状监测点覆盖率为32.35%,2019-2022年,症状监测累计报告就诊患者3976例,以县(区)和乡镇级医疗机构报告最多,在报告的可疑症状中以诊断不明或久治不愈的慢性(3个月以上)皮肤病报告最多。对单病种进行排序,位居前5位的分别是湿疹、银屑病、过敏性皮炎、荨麻疹、神经性皮炎。累计确诊麻风病7例,各年度报告日期和确诊日期间隔天数差异无统计学意义(χ^(2)=2.829,P=0.243)。诊断延迟期最长26年,最短20个月,平均8年;患者就诊延迟期最长26年,最短20个月,平均8年;医疗机构诊断延迟期最长1个月,最短0个月,平均1个月。在确诊病例中出现眉毛稀疏脱落、酒醉样面容的占100.00%,诊断不明或久治不愈的慢性(3个月以上)皮肤病和皮肤闭汗(局部干燥)或感觉异常的占71.43%。结论甘肃省须持续加强麻风病症状监测,充分发挥症状监测在麻风病早期发现中的预警作用,有效降低畸残发生。

Objective To analyze symptom surveillance data of leprosy in Gansu province from 2019 to 2022 and provide evidence for further improvement of leprosy symptom surveillance system.Methods A cross-sectional study was conducted by using the patient information during 2019–2022 collected from National Leprosy Management Information System for a descriptive analysis.Results The coverage rate of symptom surveillance was 32.35%in Gansu at the end of 2022.During 2019–2022,a total of 3976 patients were reported to have medical care seeking,with the highest report in medical units at the county and township levels.In the reported suspected symptoms,the most common one was chronic skin illness with unknown diagnosis or prolonged treatment(lasting over three months).The top five single illness were eczema,psoriasis,allergic dermatitis,urticaria,and neurodermatitis.Seven cases of leprosy were confirmed,the difference in the interval between reporting and confirmation was not significant(χ^(2)=2.829,P=0.243).The diagnosis delay ranged from 26 years to 20 months with an average of 8 years.The medical treatment delay ranged from 1 month to 0 months with an average of 1 month.Sparse eyebrow or eyebrow loss and leonine faces appearance could be seen in all confirmed cases.Undiagnosed or long-standing skin illness and localized skin dryness(sweat gland closure)or paresthesia were observed in 71.43%of the cases with unclear diagnoses.Conclusion It is necessary to further strengthen leprosy symptom surveillance and early warning to reduce the incidence of monstrosity and disability effectively.