2022年全国内脏利什曼病疫情特征分析

doi:10.12140/j.issn.1000-7423.2023.06.002

中国寄生虫学与寄生虫病杂志 ›› 2023, Vol. 41 ›› Issue (6): 669-676.doi: 10.12140/j.issn.1000-7423.2023.06.002

2022年全国内脏利什曼病疫情特征分析

李元元¹(), 周正斌¹, 杨丽敏¹, 李中秋¹, 刘琴¹, 张仪¹^,²^,^*(), 李石柱¹^,²

1 中国疾病预防控制中心寄生虫病预防控制所（国家热带病研究中心），传染病溯源预警与智能决策全国重点实验室，国家卫生健康委员会寄生虫病原与媒介生物学重点实验室，世界卫生组织热带病合作中心，科技部国家级热带病国际研究中心，上海 200025
2 上海交通大学医学院-国家热带病研究中心全球健康学院，上海 200025

收稿日期:2023-11-16 修回日期:2023-12-01 出版日期:2023-12-30 发布日期:2023-12-27
通讯作者: * 张仪（1966-），女，硕士，研究员，从事寄生虫病预防控制工作。E-mail: zhangyi@nipd.chinacdc.cn
作者简介:李元元（1989-），女，硕士，助理研究员，从事寄生虫病预防控制工作。E-mail：liyy@nipd.chinacdc.cn
基金资助:
国家重点研发计划(2021YFC2300800);国家重点研发计划(2021YFC2300804);上海市青年科技英才扬帆计划(21YF1452200)

Epidemiological characteristics of visceral leishmaniasis in China in 2022

LI Yuanyuan¹(), ZHOU Zhengbin¹, YANG Limin¹, LI Zhongqiu¹, LIU Qin¹, ZHANG Yi¹^,²^,^*(), LI Shizhu¹^,²

1 National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases; Key Laboratory on Parasite and Vector Biology, Ministry of Health; WHO Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai 200025, China
2 School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received:2023-11-16 Revised:2023-12-01 Online:2023-12-30 Published:2023-12-27
Contact: * E-mail: zhangyi@nipd.chinacdc.cn
Supported by:
National Key Research and Development Program(2021YFC2300800);National Key Research and Development Program(2021YFC2300804);Shanghai Sailing Program(21YF1452200)

摘要/Abstract

摘要：

目的了解2022年全国内脏利什曼病的疫情状况，为制定防治对策提供科学依据。方法收集2022年国家传染病报告信息管理系统中报告的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，采用Microsoft Excel 2016软件建立数据库，并对内脏利什曼病报告疫情进行描述性流行病学分析。结果 2022年全国11个省（自治区、直辖市）的104个县共报告内脏利什曼病239例，其中犬源型流行区病例191例，野生动物源型流行区病例4例，人源型流行区病例2例，非流行区输入性病例42例。病例主要分布于山西（110例）、陕西（34例）、河南（23例）和河北（23例）等4个省，合计占全国报告病例总数的79.30%（190/239）。全国65个县为流行区，共报告本地感染病例197例；其余39个县为非流行区，共报告输入性病例42例。山西省平定县（25例）、阳泉市郊区（15例）、河北省井陉县（16例）和陕西省华州区（10例）为主要流行县，报告病例占全国总报告病例数的27.62%（66/239）。内脏利什曼病复燃流行县主要集中在山西省（沁水县、高平市、浮山县、侯马市、翼城县、绛县、垣曲县、文水县）、河北省（井陉矿区、赞皇县、临城县、信都区）、河南省（偃师区、上街区、淇滨区）、北京市（昌平区）和新疆（第一师2团），共报告本地感染病例23例。内脏利什曼病报告病例高峰为7月份，男女病例数比为1 ∶ 0.38。农民和婴幼儿是我国内脏利什曼病的高风险人群，分别占报告病例总数的53.97%（129/239）和16.74%（40/239，≥ 15岁年龄组占81.17%（194/239）。结论我国内脏利什曼病呈低度流行态势，但流行区范围逐渐扩大，犬源型内脏利什曼病流行区报告病例数呈上升趋势。

关键词: 内脏利什曼病, 疫情, 分布, 中国

Abstract:

Objective To understand the epidemic situation of visceral leishmaniasis in China in 2022 and provide scientific basis for formulating prevention and control strategy. Methods Data of visceral leishmaniasis in 2022 was collected from the web-based National Infectious Diseases Reporting Information Management System. After excluding suspected cases, duplicates and cutaneous leishmaniasis cases, a visceral leishmaniasis database was established and underwent descriptive epidemiological analysis with Microsoft Excel 2016. Results A total of 239 cases of visceral leishmaniasis were reported in 104 counties of 11 provinces (autonomous regions and municipalities) in 2022, among them 191 cases were reported from mountain-type zoonotic visceral leishmaniasis endemic areas, 4 cases from desert-type zoonotic visceral leishmaniasis endemic areas, 2 cases from anthroponotic visceral leishmaniasis endemic areas and 42 cases were imported from non-endemic areas. These cases were mainly distributed in Shanxi (110 cases), Shaanxi (34 cases), Henan (23 cases) and Hebei (23 cases), the total reported accounting for 79.30% (190/239) of the overall total in China. A total of 197 local transmitted cases were reported from 42 endemic counties and other 63 counties were of non-endemic areas, reporting 39 imported cases. Pingding County, outer suburbs of Yangquan City, Jingxing County and Huazhou District were the major endemic counties with 25, 15, 16 and 10 cases reported respectively, the total accounting for 27.62% (66/239) of the overall total cases in China. Recurrence endemic counties of visceral leishmaniasis were mainly concentrated in Shanxi (Qinshui County, Gaoping City, Fushan County, Houma City, Yicheng County, Jiangxian County, Yuanqu County, Wenshui County), Hebei (Mining district of Jingxing County, Zanhuang County, Lincheng County, Xindou District), Henan (Yanshi District, Shangjie District, Qibin District), Beijing (Changping District) and Xinjiang (2th regiment farm) in 2022, with a total of 23 local cases reported. The peak incidence occurred in July. The ratio of male to female cases was 1 ∶ 0.38. Farmers, infants and young children are the high-risk population of visceral leishmaniasis, accounted for 53.97% (129/239) and 16.74% (40/239) of the total cases respectively. The reported cases at age of ≥ 15 accounted for 81.17% (194/239). Conclusion Visceral leishmaniasis is at a low prevalence status in China, whereas the endemic area is gradually expanding, and the number of cases is gradually increasing in mountain-type zoonotic visceral leishmaniasis endemic area.

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

中图分类号:

R531.6

李元元, 周正斌, 杨丽敏, 李中秋, 刘琴, 张仪, 李石柱. 2022年全国内脏利什曼病疫情特征分析[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(6): 669-676.

LI Yuanyuan, ZHOU Zhengbin, YANG Limin, LI Zhongqiu, LIU Qin, ZHANG Yi, LI Shizhu. Epidemiological characteristics of visceral leishmaniasis in China in 2022[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2023, 41(6): 669-676.

图/表 4

表1

2022年全国内脏利什曼病报告病例地区分布及其流行类型

流行类型 Epidemiological type	省（自治区、直辖市） Province (autonomous region, municipalitiy)	流行县（报告病例数/例） Endemic counties (No. reported case)
人源型 Anthroponotic visceral leishmaniasis	新疆 Xinjiang	阿图什市 Artosh (1)，阿克陶县 Akto County (1)
野生动物源型 Desert-type zoonotic visceral leishmaniasis	新疆 Xinjiang	伽师县 Jiashi County (1)，50团场 50th regiment farm (1)，2团场 2th regiment farm (1)
野生动物源型 Desert-type zoonotic visceral leishmaniasis	甘肃 Gansu	敦煌市 Dunhuang City (1)
犬源型 Mountain-type zoonotic visceral leishmaniasis	甘肃 Gansu	舟曲县 Zhouqu County (4)，宕昌县 Dangchang County (2)，迭部县 Diebu County (1)，礼县 Lixian County (1)，武都区 Wudu District (1)，镇原县 Zhenyuan County (1)，麦积区 Maiji District (1)
	山西 Shanxi	平定县 Pingding County (25)，阳泉市郊区 Outer suburbs of Yangquan City (15)，阳泉市矿区 Mining district of Yangquan City (9)，曲沃县 Quwo County (8)，乡宁县 Xiangning County (7)，浮山县 Fushan County (5)，阳泉市城区 Urban district of Yangquan City (4)，盂县 Yuxian County (4)，昔阳县 Xiyang County (4)，襄垣县 Xiangyuan County (4)，襄汾县 Xiangfen County (3)，河津市 Hejin City (3)，潞城区 Lucheng District (3)，尧都区 Yaodu District (2)，武乡县 Wuxiang County (2)，绛县 Jiangxian County (2)，高平市 Gaoping City (1)，沁水县 Qinshui County (1)，和顺县 Heshun County (1)，榆社县 Yushe County (1)，侯马市 Houma City (1)，翼城县 Yicheng County (1)，文水县 Wenshui County (1)，垣曲县 Yuanqu County (1)
	陕西 Shaanxi	华州区 Huazhou District (10)，韩城市 Hancheng City (5)，宁强县 Ningqiang County (1)，临渭区 Linwei District (1)，延川县 Yanchuan County (1), 延长县 Yanchang County (1)，宜川县 Yichuan County (1)，绥德县Suide County (1)
	四川 Sichuan	九寨沟县 Jiuzhaigou County (2)，茂县 Maoxian County (1)
	河南 Henan	林州市 Linzhou City (6)，巩义市 Gongyi City (6)，登封市 Dengfeng City (3)，新安县 Xin’an County (2)，龙安区 Long’an District (1)，淇滨区 Qibin District (1)，偃师区 Yanshi District (1)，上街区 Shangjie District (1)，新密市 Xinmi City (1)
	河北 Hebei	井陉县 Jingxing County (16)，高碑店市 Gaobeidian City (2)，井陉矿区Mining district of Jingxing County (1)，鹿泉区 Luquan District (1)，赞皇县 Zanhuang County (1)，临城县 Lincheng County (1)，信都区 Xindu District (1)
	北京 Beijing	昌平区 Changping District (2)，门头沟区 Mentougou District (1)

表1

表2

图1

表3

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	(罗卓韦, 周正斌, 公衍峰, 等. 我国内脏利什曼病的流行现状和防控挑战[J]. 中国寄生虫学与寄生虫病杂志, 2022, 40(2): 146-152.)
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	(陈海棠, 汪俊云, 朱雪花. 我国非流行省内脏利什曼病病例流行病学分析[J]. 国际医学寄生虫病杂志, 2011, 38(3): 177-179.)
[40]	Snider H, Lezama-Davila C, Alexander J, et al. Sex hormones and modulation of immunity against leishmaniasis[J]. Neuroimmunomodulation, 2009, 16(2): 106-113. doi: 10.1159/000180265 pmid: 19212130

县（市、区） County (city, district)	流行类型 Epidemiological type	报告病例数/例 No. reported case	人口数 Population^a	发病率/1·10 000^-1 Incidence rate/1·10 000^-1
山西平定县 Pingding County, Shanxi	犬源型 MT-ZVL	25	306 200	0.8
山西阳泉市郊区 Outer suburbs of Yangquan City, Shanxi	犬源型 MT-ZVL	15	275 100	0.6
河北井陉县 Jingxing County, Hebei	犬源型 MT-ZVL	16	251 000	0.6
陕西华州区 Huazhou District, Shaanxi	犬源型 MT-ZVL	10	268 600	0.4

特征 Feature	流行区 Endemic area						非流行区 Non-endemic area		合计 Total
	人源型 Anthroponotic visceral leishmaniasis		野生动物源型 Desert-type zoonotic visceral leishmaniasis		犬源型 Mountain-type zoonotic visceral leishmaniasis		非流行区 Non-endemic area		合计 Total
	报告病例数/例 No. reported case	构成比/% Composition rate/%	报告病例数/例 No. reported case	构成比/%Composition rate/%	报告病例数/例 No. reported case	构成比/%Composition rate/%	报告病例数/例 No. reported case	构成比/%Composition rate/%	报告病例数/例 No. reported case	构成比/%Composition rate/%
年龄组/岁 Age group/Year
0~2	1	1/2	1	1/4	26	13.6	4	9.5	32	13.4
3~6	0	0	1	1/4	8	4.2	0	10.3	9	3.8
7~14	0	0	0	0	4	2.1	0	0.0	4	1.7
≥ 15	1	1/2	2	2/4	153	80.1	38	90.5	194	81.2
职业 Occupation
婴幼儿 Infants and young children	1	1/2	2	2/4	33	17.3	4	9.5	40	16.7
学生 Students	0	0	0	0	7	3.7	0	0.0	7	2.9
农民 Peasants	0	0	2	2/4	106	55.5	21	50.0	129	54.0
工人 Workers	0	0	0	0	6	3.1	3	7.1	9	3.8
离退人员 Retired personnel	0	0	0	0	12	6.3	0	0.0	12	5.0
家务及待业 Housewives	0	0	0	0	16	8.4	5	11.9	21	8.8
商务服务 Business services	1	1/2	0	0	2	1.1	4	9.5	7	2.9
其他 Others	0	0	0	0	9	5.4	5	11.9	14	5.9
性别 Gender
男 Male	1	1/2	1	1/4	142	74.4	29	69.1	173	72.4
女 Female	1	1/2	3	3/4	49	25.7	13	31.1	66	27.6
总计 Total	2	2/2	4	4/4	191	100.0	42	100.0	239	100.0

2022年全国内脏利什曼病疫情特征分析

Epidemiological characteristics of visceral leishmaniasis in China in 2022

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