新疆生产建设兵团黑热病流行病学特征及时空聚类分析

Epidemiological characteristics and spatio-temporal clustering of leishmaniasis in Xinjiang Province and the Production and Construction Corps

目的分析新疆生产建设兵团(以下简称兵团)地区黑热病流行现状和时空聚类特征,为疫情监测和防控措施的制定提供依据。方法收集兵团地区2004-2018年黑热病的疫情报告数据,采用描述流行病学方法分析黑热病的三间分布情况,并应用SaTScan 9.6和ArcGIS 10.2软件进行时空聚类分析。结果兵团地区2004-2018年累计报告黑热病103例,年均发病率为0.26/10万;死亡1例,病死率为0.97%。兵团地区在2005年出现了一次暴发流行,2006-2008年发病率呈上升趋势,2009年后发病率下降,2013年发病率降至0。2014年疫情有小幅回升,部分地区又出现小的暴发点。每月均有病例发生,以10-12月为发病高峰期,4-6月发病数较少。患者男女性别比为1.51∶1;患者以<3岁散居儿童多见。病例主要分布在9个师24个团场,大部分病例分布在南疆,其中第三师90例,占87.38%。时空聚类分析显示,兵团地区共探测到2个有意义的时空聚集区域,分别是以第三师伽师农场和第四师67团为聚集中心。结论兵团地区2004-2018年黑热病发病总体呈低发病率趋势,但每年在主要流行区仍有病例出现,因此应加强对重点流行区和高危人群的监测,做好黑热病的防控。

Objective To analyze the epidemiological characteristics and spatio-temporal clustering of leishmaniasis in Xinjiang Province and the Production and Construction Corps in order to provide evidence surveillance and prevention of the disease.Methods Data on the incidence of leishmaniasis reported in Xinjiang Province and the Production and Construction Corps between 2004 and 2018 were collected and statistically analyzed using SPSS 20.0 and Excel 2007,and spatio-temporal data clustering was performed using the software SaTScan 9.04 and ArcGIS 10.2.Results During the period in which the Production and Construction Corps was observed,a total of 103 cases of leishmaniasis were reported,with an average annual incidence of 0.26/100,000,and a total of 1 death due to the disease.Mortality was 0.97%.In the Corps area,there was an outbreak in 2005.From 2006 to 2008,incidence tended to increase and then declined substantially starting in 2009.In 2013,the incidence rate dropped to zero but rose again slightly in 2014 with small outbreaks in some regions.Cases(48.54%of all cases)were mainly concentrated between October and December,with fewer cases from April to June.The male to female ratio of patients was 1.51:1.Most cases involved children between 0 and 3 years of age living separately from their patients.The cases of kala-azar were mainly distributed in 24 farms of 9 divisions,most of which are distributed in southern Xinjiang.Most cases occurred in the Third Division(90 cases,87.38%).Two meaningful spatio-temporal clusters were detected in the Corps area:the Jiashi Farm of the Third Division(RR=57.23,P<0.01)and the 67 th Group of the Fourth Division(RR=3.79,P<0.01).Conclusion The incidence of kala-azar in the Corps area was generally low from 2004 to 2018,but there still were cases in the main epidemic areas every year.Therefore,monitoring of key epidemic areas and high-risk groups should be enhanced to prevent and control kala-azar.