中国寄生虫学与寄生虫病杂志

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2014年新疆伽师县内脏利什曼病暴发的调查分析

伊斯拉音·乌斯曼1 *,阿迪力·司马义1,凯赛尔·克尤木2,麦麦提艾力·阿卜力米提3,季芳4,侯岩岩1,张松1,亚力坤·买买提依明1,茹孜古丽·朱马洪1   

  1. 1 新疆维吾尔自治区疾病预防控制中心,乌鲁木齐 830002;2 新疆喀什地区疾病预防控制中心,喀什 844000;3 新疆伽师县卧里托格拉克乡卫生院,伽师 844300;4 新疆伽师县疾病预防控制中心,伽师 844300
  • 出版日期:2015-10-30 发布日期:2016-01-06

Investigation on the Outbreak of Visceral Leishmaniasis in 2014 in Jiashi County of Xinjiang

OSMAN Yisilayin1 *, SIMAYI Adili1, KEYUMU Kaisuer2, ABLIMIT Maimaitiaili3, JI Fang4, HOU Yan-yan1, ZHANG Song1, MAIMAITIYIMIN Yalikun1, JUMAHUN Ruziguli1   

  1. 1 The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830002,China; 2 The Center for Disease Control and Prevention of Kashi Prefecture,Kaxgar,Xinjiang 844000,China; 3 Gholtoghrakh Township Hospital of Jiashi County,Jiashi,Xinjiang 844300,China; 4 The Center for Disease Control and Prevention of Jiashi County,Jiashi,Xinjiang 844300,China
  • Online:2015-10-30 Published:2016-01-06

摘要:

目的 了解2014年新疆维吾尔自治区(简称新疆)伽师县内脏利什曼病暴发的流行病学特点,为制定相关防治策略提供依据。 方法 从中国疾病预防控制中心传染病报告信息管理系统(简称报告系统)中收集新疆上报的2009年7月1日-2015年6月30日内脏利什曼病疫情数据,进行整理分析。于2014年10月对当年7月1日以来报告内脏利什曼病例数剧增的伽师县卧里托格拉克乡、和夏阿瓦提乡的23个村(3岁以下儿童)开展现场流行病学调查,对有发热,肝、脾肿大等症状和体征者(为疑似病例)采集手指血20 μl(监护人知情同意)进行rk39免疫层析试条检测,并对阳性患儿给予葡萄糖酸锑纳(200 mg/kg×6次,静脉给药)治疗。 结果 2009年7月1日-2015年6月30日新疆共报告内脏利什曼病813例,其中伽师县占41.45%(337/813);2014年7月1日-2015年6月30日共报告病例数为192例,其中伽师县占86.46%(166/192)。2014年在伽师县,自8月出现首个内脏利什曼病例后,报告病例数呈上升的趋势,10、11和12月报告病例数为114例,占当期报告病例数的68.7%(114/166),至2015年4月无病例报告。2014年7月1日-2015年6月30日,伽师县报告的166例内脏利什曼病病例中,年龄为出生23 d~8岁,其中1岁以下占95.18%(158/166);伽师县卧里托格拉克乡报告的113例中,年龄为出生23 d~3岁,其中1岁以下占96.46%(109/113),符合荒漠型内脏利什曼病流行的特点。现场调查和夏阿瓦提乡和卧里托格拉克乡23个村3岁以下儿童833人,其中14例疑似病例经rk39免疫层析试条检测,阳性者11例,均经葡萄糖酸锑纳治疗1个疗程后治愈出院。 结论 2014年伽师县内脏利什曼病报告疫情中95%为1岁以下儿童,确定为荒漠型内脏利什曼病暴发。

关键词: 新疆维吾尔自治区, 伽师县, 内脏利什曼病, 暴发

Abstract:

 Objective To understand the epidemiological characteristics of visceral leishmaniasis(VL) outbreak in Jiashi County of Xinjiang Uygur Autonomous Region in 2014, and provide basis for VL prevention and control strategies.  Methods Data on VL epidemic situation in Xinjiang from July 1, 2009 to June 30, 2015 were collected from Chinese CDC Infectious Disease Reporting Information Management System (reporting system). On-site epidemiological investigation was conducted in October, 2014, among children under 3 years in 23 villages in Gholtoghrak Township and Koxawat Township in Jiashi County, regions that had dramatically increased reports of VL cases from July 1. For suspected cases who showed symptoms such as fever and hepato-splenomegaly, blood (20 μl) was collected through fingerstick (with parental guardian consent) for rk39 immunochromatographic strip testing. Children with positive results were given sodium stibogluconate treatment (6×200 mg/kg, intravenously). Results A total of 637 VL cases were reported in Xinjiang from July 1, 2009 to June 30, 2015. Among the 192 cases reported from July 1, 2014 to June 30, 2015 in Xinjiang, cases from Jiashi County occupied 86.46% (166/192) of the cases. The number of VL cases in Jiashi County showed a trend of increase since the first report in August, with a total number of 114 in October, November and December. The 166 cases in Jiashi County had an age range of 23 days-8 years, with those under one year accounting for 95.18%(158/166). The 113 cases in Gholtoghrak Township of the County had an age range of 23 days-3 years, with those under one year accounting for 96.46% (109/113). The age-distribution of VL casess in the County accorded with the characteristic of the desert type. On-site investigation of 833 children in the 23 villiages revealed 11 children with positive results of rk39 immunochromatographic strip testing out of 14 suspected cases, all recovered after one course of sodium stibogluconate treatment. Conclusion In 2014, VL outbreak occurs in Jiashi County with 95% of the cases being children under one year old. This outbreak was identified to be the desert type.

Key words: Xinjiang Uygur Autonomous Region, Jiashi County, Visceral leishmaniasis, Outbreak