2018年全国内脏利什曼病疫情分析

doi:10.12140/j.issn.1000-7423.2020.02.007

摘要/Abstract

摘要：

目的了解2018年全国内脏利什曼病的疫情状况。方法收集2018年中国疾病预防控制中心传染病报告信息管理系统中全国内脏利什曼病病例信息,剔除疑似病例、重复病例以及皮肤利什曼病病例,建立数据库,采用Microsoft Excel 2016软件对内脏利什曼病病例的三间分布进行描述性流行病学分析。结果 2018年全国11个省份的78个县共报告内脏利什曼病180例,病例主要分布于甘肃（66例）、山西（38例）和陕西（27例）等3个省。其中40个县属于流行区,共报告本地感染病例134例,其余38个县属于非流行区,共报告输入性病例46例。其中甘肃省舟曲县（22例）、宕昌县（18例）和武都区（10例）为主要流行县,报告病例占全国总报告病例数的27.8%（50/180）。陕西省渭南市化州区和临渭区再现本地感染病例,为内脏利什曼病复燃流行县。内脏利什曼病发病高峰为4-6月,男女病例比为1 ∶ 0.7。农民和儿童是我国内脏利什曼病高风险人群,分别占全部病例数的42.2%（76/180）和34.5%（55/180）。内脏利什曼病病例主要分布于≥ 15岁年龄组,不同流行类型病例年龄分布明显不同,野生动物源型病例主要分布于0~2岁婴幼儿,人源型与犬源型病例主要分布于≥ 15岁农民。结论我国内脏利什曼病呈低度流行态势,但流行区范围逐渐蔓延。

关键词: 中国, 内脏利什曼病, 疫情, 分布

Abstract:

Objective To understand the prevalence of visceral leishmaniasis in China in 2018.Methods Information of visceral leishmaniasis cases in 2018 was collected from the web-based National Diseases Reporting Information System (NDRIS) operated by the Chinese Center for Disease Control and Prevention. A database was established, excluding suspected cases, duplicates and cutaneous leishmaniasis cases. The three-dimensional distribution of visceral leishmaniasis cases was descriptively analyzed using Microsoft Excel 2016.Results In 2018 a total of 180 cases of visceral leishmaniasis were reported in 78 counties of 11 provinces (autonomous regions and municipalities), mainly distributed in Gansu (66 cases), Shanxi (38) and Shaanxi Provinces (27). Forty counties were endemic regions of visceral leishmaniasis, with a total of 134 reported indigenous cases, and the other 38 counties were non-endemic regions, with a report of 46 imported cases of visceral leishmaniasis. Particularly, Zhouqu county, Dangchang county and Wudu district were the major prevalent counties with 22, 18 and 10 cases reported, respectively, accounting for 27.8% (50/180) of the total cases reported. The Huazhou district and Linwei district of Weinan City in Shaanxi Province reported re-emergence of indigenous visceral leishmaniasis cases, being recognized as the visceral leishmaniasis-reemerging regions. The occurrence of visceral leishmaniasis peaked from April to June, with a male/female ratio of 1 ∶ 0.7. Farmers and children were at a high risk of visceral leishmaniasis, accounting for 42.2% (76/180) and 34.5% (55/180) of the total, respectively. The visceral leishmaniasis cases were mainly distributed in the people at ages of ≥15 years. The age distribution varied significantly among different types of the disease, with the desert-type zoonotic visceral leishmaniasis distributed mainly in infants of age 0-2 years, and the anthroponotic and mountain-type zoonotic visceral leishmaniasis distributed mainly in farmers aged ≥15 years.Conclusion The visceral leishmaniasis is endemic at low prevalence in China, but the endemic area is extending gradually.

Key words: Visceral leishmaniasis, Epidemic status, Distribution, China

中图分类号:

R531.6

周正斌, 李元元, 张仪, 李石柱. 2018年全国内脏利什曼病疫情分析[J]. 中国寄生虫学与寄生虫病杂志, 2020, 38(2): 175-181.

ZHOU Zheng-bin, LI Yuan-yuan, ZHANG Yi, LI Shi-zhu. Prevalence of visceral leishmaniasis in China in 2018[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2020, 38(2): 175-181.

图/表 4

表1

2018年全国内脏利什曼病病例地区分布及流行类型

地区Region	流行类型 Endemic type				病例数 No. of cases		构成比/% Composition rate/%
地区Region	人源型AVL	野生动物源型DST-ZVL	犬源型 MST-ZVL		病例数 No. of cases		构成比/% Composition rate/%
甘肃省 Gansu Province
流行县（8个）Endemic counties (8)
宕昌县 Dangchang County			是Yes		18		10.0
迭部县Diebu County			是Yes		2		1.1
礼县 Li County			是Yes		1		0.6
秦州区 Qinzhou District			是Yes		1		0.6
庆城县 Qingcheng County			是Yes		1		0.6
文县 Wenxian County			是Yes		4		2.2
武都区 Wudu District			是Yes		10		5.6
舟曲县 Zhouqu County			是Yes		22		12.2
小计Subtotal					59		32.8
非流行县（6个）Non-endemic counties (6)					7		3.9
合计Total					66		36.7
河南省 Henan Province
流行县（1个）Endemic county (1)
林州市 Linzhou City			是Yes		2		1.1
非流行县（1个）Non-endemic county (1)					1		0.6
合计Total					3		1.7
地区Region		流行类型 Endemic type				病例数 No. of cases	构成比/% Composition rate/%
地区Region		人源型AVL	野生动物源型DST-ZVL	犬源型 MST-ZVL		病例数 No. of cases	构成比/% Composition rate/%
山西省Shanxi Province
流行县（10个）Endemic counties (10)
阳泉市城区Urban of Yangquan City				是Yes		5	2.8
大宁县 Daning County				是Yes		1	0.6
阳泉市郊区Suburb district of Yangquan City				是Yes		7	3.9
阳泉市矿区Mining district of Yangquan City				是Yes		3	1.7
长治市郊区 Suburb of Changzhi City				是Yes		1	0.6
平定县 Pingding County				是Yes		8	4.4
曲沃县 Quwo County				是Yes		3	1.7
武乡县 Wuxiang County				是Yes		1	0.6
乡宁县 Xiangning County				是Yes		1	0.6
襄汾县Xiangfen County				是Yes		1	0.6
小计Subtotal						31	17.2
非流行县（6个）Non-endemic counties (6)						7	3.9
合计Total						38	21.1
陕西省 Shaanxi Province
流行县（6个）Endemic counties (6)
韩城市 Hancheng City				是Yes		8	4.4
华州区 Huazhou District				是Yes		1	0.6
临渭区 Linwei District				是Yes		2	1.1
清涧县 Qingjian County				是Yes		1	0.6
绥德县 Suide County				是Yes		1	0.6
宜川县 Yichuan County				是Yes		2	1.1
小计Subtotal						15	8.3
非流行县（6个）Non-endemic counties (6)						12	6.7
合计Total						27	15.0
四川省 Sichuan Province
流行县（3个）Endemic counties (3)
黑水县 Heishui County				是Yes		2	1.1
九寨沟县 Jiuzhaigou County				是Yes		7	3.9
理县 Li County				是Yes		1	0.6
小计Subtotal						10	5.6
非流行县（7个）Non-endemic counties (7)						7	3.9
合计Total						17	9.4
新疆Xinjiang
流行县（12个）Endemic counties (12)
喀什市 Kashgar City		是Yes				4	2.2
库车县 Kuqa County		是Yes				1	0.6
阿克苏市Aksu City		是Yes				1	0.6
阿图什市Artux City		是Yes				1	0.6
疏勒县 Shule County		是Yes				1	0.6
英吉沙县 Yengisar County		是Yes				3	1.7
巴楚县 Bachu County			是Yes			1	0.6
策勒县 Qira County			是Yes			1	0.6
伽师县 Jiashi County			是Yes			1	0.6
且末县 Qiemo County			是Yes			1	0.6
岳普湖县 Yopurga County			是Yes			1	0.6
新疆生产建设兵团第50农场The 50th Regiment Farm of Xinjiang Construction Corps			是Yes			1	0.6
小计Subtotal						17	9.4
非流行农场（1个）Non-endemic county (1)						1	0.6
合计Total						18	10.0
其他5个非流行省份11个非流行县11 non-endemic counties in other 5 non-endemic provinces						11	6.1
总计Total		6	6	28		180	100

表1

表2

图1

表3

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流行县Prevalent county	流行类型Endemic type	病例数No. of cases	占总病例的比例/%Proportion in all the cases/%	人口数Population size	发病率/100 000^-1 Incidence/100 000^-1
舟曲县Zhouqu County	犬源型MST-ZVL	22	12.2	138 507	1.6
宕昌县Dangchang County	犬源型MST-ZVL	18	10.0	280 369	0.6
武都区Wudu District	犬源型MST-ZVL	10	5.6	563 285	0.2

特征Feature	流行区Endemic area								非流行区 Non-endemic area
	人源型AVL		野生动物源型DST-ZVL		犬源型MST-ZVL		合计Total		非流行区 Non-endemic area
	病例数 No. of cases	构成比/%Composition rate/%	病例数 No. of cases	构成比/%Composition rate/%	病例数 No. of cases	构成比/%Composition rate/%	病例数 No. of cases	构成比/%Composition rate/%	病例数 No. of cases	构成比/%Composition rate/%
年龄组/岁Age group/years
0~2	1	9.1	4	66.7	29	24.8	34	25.4	4	8.7
3~6	1	9.1	1	16.7	11	9.4	13	9.7	3	6.5
7~14	1	9.1	0	0	11	9.4	12	9.0	3	6.5
≥ 15	8	72.7	1	16.7	66	56.4	75	56.0	36	78.3
职业Occupation
婴幼儿Infants and young children	2	18.2	5	83.3	41	35.0	48	35.8	7	15.2
学生Students	1	9.1	0	0	12	10.3	13	9.7	3	6.5
农民Peasants	3	27.3	1	16.7	47	40.2	51	38.1	25	54.3
工人Workers	1	9.1	0	0	3	2.6	4	3.0	2	4.3
干部职员Officials	0	0	0	0	5	4.3	5	3.7	1	2.2
家务及待业Housewives	4	36.4	0	0	5	4.3	9	6.7	4	8.7
其他Others	0	0	0	0	4	3.4	4	3.0	4	8.7
性别Gender
男Male	5	45.5	6	100	72	61.5	83	61.9	26	56.5
女Female	6	54.5	0	0	45	38.5	51	38.1	20	43.5
合计Total	11	100	6	100	117	100	134	100	46	100