2010—2019年山西省人群内脏利什曼病流行特征分析

doi:10.12140/j.issn.1000-7423.2021.03.009

摘要/Abstract

摘要：

目的掌握山西省人群内脏利什曼病流行特征和变化趋势,为制定内脏利什曼病防治策略提供依据。方法收集2010—2019年国家传染病报告信息管理系统中现住址为山西省的内脏利什曼病报告病例,用描述性流行病学方法对山西省内脏利什曼病病例流行特征进行分析。收集报告病例个案流行病学调查信息,分析流行县变化情况。结果 2010—2019年山西省累计报告内脏利什曼病140例,其中本地病例131例,输入性病例7例,2例感染来源不明,年均报告发病率为0.04/10万。2010—2014年每年报告病例数不超过4例,自2015年起山西省内脏利什曼病疫情呈逐年上升趋势,2015—2019年报告发病数分别为8、9、18、37和52例,且疫情波及范围逐年扩大,2019年疫情较重的两个县（区）（平定县、阳泉市郊区）报告病例数均超过10例。报告病例主要集中在阳泉市、长治市、临汾市,3个市报告病例数占全省报告病例总数的92.14%（129/140）。阳泉市报告病例数增加较多,由2016年的4例增加至2019年的33例。2010—2019年山西省共8个新增流行县,分布在阳泉（3个）、长治（2个）、临汾（2个）和运城（1个）等4个市;6个复燃流行县分布在长治（1个）、晋中（1个）、阳泉（1个）、临汾（3个）等4个市。男性和女性分别为98例和42例,男女性别比为2.33 ∶ 1。0~2岁婴幼儿占全部报告病例的39.29%（55/140）,发病高峰年龄为1岁组的婴儿。散居儿童和农民为内脏利什曼病的高风险人群,分别占总病例数的41.13%（58/140）和28.37% (40/140)。现居住地为农村的病例最多,占85.00%（119/140）。结论山西省内脏利什曼病疫情增长趋势明显,波及范围逐年扩大,不断出现新的流行区,部分地区出现疫情复燃,疫情分布呈现明显的地区性。

关键词: 内脏利什曼病, 流行病学特征, 分析, 山西省

Abstract:

Objective To understand the epidemic status and transmission trend of kala-azar in Shanxi Province, and to provide informative basis for formulating appropriate control strategy for kala-azar. Methods Information of kala-azar cases who were residents in Shanxi Province, reported from 2010 to 2019 from the National infectious Disease Surveillance Reporting and Management System, was collected for a descriptive epidemiological analysis. In addition, epidemiological investigation information of the reported cases was collected individually to analyze the change of epidemic situation of kala-azar in different counties.Results A total of 140 cases of kala-azar were reported in Shanxi from 2010 to 2019, with an annual average incidence of 0.04 per 100 000. Among them, 131 were local cases, 7 were imported cases, and the source of infection in 2 cases was unknown. No more than 4 kala-azar cases were reported each year in 2010—2014, but the reported yearly incidence showed a trend of increase from 2015 to 2019 (8 cases, 9 cases, 18 cases, 37 cases and 52 cases respectively). Furthermore, the epidemic area expanded year by year. More than 10 cases were reported in the two counties where the kala-azar endemicity was higher severe in 2019. The reported cases were mainly in cities of Yangquan, Changzhi and Linfen, accounting for 92.14% (129/140) of the total. The reported cases of kala-azar were significantly increased from 4 in 2016 to 33 in 2019 in Yangquan City, while the epidemic situation was relatively stable in Linfen and Changzhi. During 2010-2019 there were eight new epidemic counties located in four cities, which were Yangquan (3 cases), Changzhi (2 cases), Linfen (2 cases) and Yuncheng (1 case), and 6 epidemic reemerging counties located in four cities, which were Changzhi (1 case), Jinzhong (1 case), Yangquan (1 case) and Linfen (3 cases). Of all cases, 98 were males and 42 were females, with a male-to-female ratio of 2.33 ∶ 1. The age distribution showed that 39.29% (55/140) of the cases were infants under 3 years, with peak age of disease onset under 1. Children and famers were at a high risk of kala-azar, accounting for 41.13% (58/140) and 28.37% (40/140), respectively. The majority of cases were residents in villages (85.00%, 119/140).Conclusion The epidemic of kala-azar in Shanxi Province shows a noticeable increasing trend, is rising with the affected areas being expanded year by year; new endemic areas continuously occurred, and reemergence appeared in some areas. The incidence shows an obvious regional distribution pattern.

Key words: Kala-azar, Epidemiological characteristics, Analysis, Shanxi

中图分类号:

R531.6

郑玉华, 白永飞, 帖萍, 闫昌福, 王婷, 王晶莹, 王三桃, 蔡剑. 2010—2019年山西省人群内脏利什曼病流行特征分析[J]. 中国寄生虫学与寄生虫病杂志, 2021, 39(3): 352-358.

ZHENG Yu-hua, BAI Yong-fei, TIE Ping, YAN Chang-fu, WANG Ting, WANG Jing-ying, WANG San-tao, CAI Jian. Epidemiological characteristics of visceral leishmaniasis in Shanxi Province, 2010—2019[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2021, 39(3): 352-358.

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2010—2019年山西省内脏利什曼病各类流行县病例数分布

年份 Year	流行县（病例数） Endemic counties (No. of cases)	新增流行县（病例数） New endemic counties (No. of cases)	复燃流行县（病例数） Re-emerging endemic counties (No. of cases)	合计Total
年份 Year	流行县（病例数） Endemic counties (No. of cases)	新增流行县（病例数） New endemic counties (No. of cases)	复燃流行县（病例数） Re-emerging endemic counties (No. of cases)	县数 No. of counties	报告病例数 No. of cases
2010	襄垣县 Xiangyuan County (1)	平定县Pingding County (1)		2	2
2011	襄垣县 Xiangyuan County (1)	长治郊区Suburb districtof Changzh (1)		4	4
	武乡县 Wuxiang County (1)	大宁县Daning County (1)
2012	武乡县Wuxiang County (1)		屯留县Tunliu County (1)	2	2
2013	阳泉郊区Suburb district of Yangquan City (1)		榆社县Yushe County (1)	4	4
	武乡县 Wuxiang County (1)
	大宁县 Daning County (1)
2014	襄垣县Xiangyuan County (1)	阳泉城区Urban of Yangquan City (1)		4	4
	武乡县 Wuxiang County (1)
	大宁县 Daning County (1)
2015	阳泉郊区Suburb district of Yangquan (2)	长治城区Urban of Changzhi City (1)		5	7
	武乡县 Wuxiang County (1)
	平定县 Pingding County (2)
	大宁县 Daning County (1)
2016	平定县Pingding County (3)		盂县Yuxian county(1)	5	9
	长治郊区 Suburb district of Changzhi (1)
	襄垣县Xiangyuan County (1)
	武乡县Wuxiang County (3)
2017	阳泉城区Urban of Yangquan City (2)	乡宁县Xiangning County (2)	曲沃县Quwo County (1)	8	18
	阳泉郊区Suburb district of Yangquan (7)		襄汾县Xiangfen County (1)
	盂县Yuxian County (1)
	襄垣县Xiangyuan County (1)
	武乡县Wuxiang County (3)
2018	阳泉城区Urban of Yangquan City (5)	矿区Mining district (3)		11	32
	阳泉郊区Suburb district of Yangquan (7)
	平定县Pingding County (8)
	长治郊区Suburb district of Changzhi (1)
	武乡县Wuxiang County (1)
	曲沃县Quwo County (3)		尧都区Yaodu district (1)
	襄汾县Xiangfen County (1)
	乡宁县Xiangning County (1)
	大宁县Daning County (1)
2019	阳泉城区Urban of Yangquan City (6)	河津市Hejing City (2)		10	49
	阳泉矿区 Mining district of Yangquan (4)
	阳泉郊区Suburb district of Yangquan City (13)
	平定县Pingding County (10)
	潞州区Luzhou district (2)
	武乡县Wuxiang County (4)
	襄汾县Xiangyuan County (4)
	乡宁县Xiangning County (3)
	大宁县Daning County (1)
合计Total	113	12	6		131

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特征 Feature	病例数 No. of cases	构成比/% Composition rate/%
职业Occupation
散居儿童Scattered children	59	42.14
农民Farmers	40	28.57
家务及待业Housewives	14	10.00
工人Workers	8	5.71
其他Others	8	5.71
学生Students	7	5.00
离退休Retirees	4	2.86
性别Gender
男Male	98	70.00
女Femal	42	30.00
现居地Place of residence
农村 Rural	119	85.00
城市Urban	21	15.00
合计Total	140	100