2005—2022年新疆喀什地区内脏利什曼病流行病学及时空分布特征

doi:10.12140/j.issn.1000-7423.2024.03.008

中国寄生虫学与寄生虫病杂志 ›› 2024, Vol. 42 ›› Issue (3): 332-339.doi: 10.12140/j.issn.1000-7423.2024.03.008

2005—2022年新疆喀什地区内脏利什曼病流行病学及时空分布特征

买买提江·吾买尔(), 亚里昆·买买提依明, 史光忠, 阿衣夏木·克尤木, 赵江山^*()

新疆维吾尔自治区疾病预防控制中心，乌鲁木齐 830002

收稿日期:2023-10-24 修回日期:2024-02-04 出版日期:2024-06-30 发布日期:2024-07-16
通讯作者: *赵江山（1984—），男，硕士，高级实验师，从事寄生虫病与布鲁氏菌病防治研究。E-mail：zjscdc@163.com
作者简介:买买提江•吾买尔（1978—），男，本科，副主任医师，从事寄生虫病与布鲁氏菌病防治研究。E-mail：853769003@qq.com
基金资助:
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开放课题(WSBKTKT2019-07)

Epidemiological and spatio-temporal distribution characteristics of visceral leishmaniasis in Kashi Prefecture, Xinjiang, 2005-2022

MAIMAITIJIANG Umar(), YALIKUN Maimaitiyiming, SHI Guangzhong, AYIXIAMU Keyoumu, ZHAO Jiangshan^*()

Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi 830002, China

Received:2023-10-24 Revised:2024-02-04 Online:2024-06-30 Published:2024-07-16
Supported by:
Open Project from the Key Laboratory of Parasite and Vector Biology, National Health Commission of the People’s Republic of China(WSBKTKT2019-07)

摘要/Abstract

摘要：

目的分析2005—2022年新疆喀什地区内脏利什曼病（VL）的流行病学特征和时空分布情况，为指导喀什地区制定VL的防控方案提供科学依据。方法收集国家传染病报告信息管理系统中2005—2022年新疆喀什地区VL报告病例数据，采用描述性流行病学分析VL的三间分布特征，使用Geoda 1.22软件进行空间自相关分析，使用SaTScan 10.1.2软件进行时空扫描统计分析。结果 2005—2022年新疆喀什地区共报告1 965例VL病例，年均发病率为0.13/10万人，2008年和2015年为发病高峰期，发病率分别为6.10/10万（363例）和8.29/10万（396例）。男性、女性报告病例分别为1 125和840例，男女性别比为1.34∶1；各年龄组中均有病例报告，主要分布在0~4岁年龄组（75.47%，1 483/1 965）；职业分布以散居儿童最多（75.32%，1 480/1 965）。2005—2022年新疆喀什地区每月均有病例报告，其中2008—2010年和2014—2016年的季节性分布较为明显，9—12月为报告高峰。2005—2022年VL报告病例主要分布在喀什地区的北部县（市），发病率最高的4个县（市）分别为伽师县（15.84/10万）、喀什市（4.10/10万）、疏附县（1.30/10万）和巴楚县（1.21/10万）。全局空间自相关分析结果显示，2012年的发病率在空间上呈现正相关性（Moran’s I = 0.126 5，Z > 1.96，P < 0.05）。局部自相关分析结果显示，高-高聚集区主要分布在疏附县、喀什市、伽师县和疏勒县。时空扫描分析结果显示，主要聚集区为伽师县，聚集的高发时间段在2008—2016年。结论 2005—2022年新疆喀什地区VL总体流行呈下降趋势，高危人群以低龄散居儿童为主，北部县（市）是VL的高流行区域。

关键词: 内脏利什曼病, 流行病学特征, 空间自相关, 时空扫描分析, 新疆喀什

Abstract:

Objective To analyze the epidemiological characteristics and spatio-temporal distribution of visceral leishmaniasis (VL) in Kashi Prefecture, Xinjiang, from 2005 to 2022, to provide a scientific basis for formulating prevention and control strategies for VL in Kashi area. Methods Data on VL cases reported in Kashi Prefecture, Xinjiang, from 2005 to 2022 were collected from the National Diseases Reporting Information System. Descriptive epidemiological methods were used to analyze the three-dimensional distribution characteristics of VL. Spatial auto-correlation analysis was performed using Geoda 1.22 software, and spatio-temporal scanning statistical analysis was performed using SaTScan 10.1.2 software. Results From 2005 to 2022, a total of 1 965 VL cases were reported in Kashi Prefecture, Xinjiang, with an average annual incidence rate of 0.13 per 100 000 people. The peak incidence years were 2008 and 2015, with incidence rates of 6.10 per 100 000 (363 cases) and 8.29 per 100 000 (396 cases), respectively. Among the population distribution characteristics, 1 125 cases were male and 840 were female, with a male-to-female ratio of 1.34 ∶ 1. Cases were reported across all age groups, with the composition rate of 75.47% (1 483/1 965) in the 0-4 years age group. The high-risk population was scattered children (75.32%, 1 480/1 965). VL cases were reported monthly from 2005 to 2022, with noticeable seasonal distribution between 2008-2010 and 2014-2016, peaking from September to December. VL mainly occurred in the northern counties of Kashi, with the highest incidence rate in Jiashi County (15.84/100 000), Kashi City (4.10/100 000), Shufu County (1.30/100 000), and Bachu County (1.21/100 000). The results of spatial auto-correlation analysis revealed a significant positive spatial correlation in the incidence of VL in Kashi Prefecture, Xinjiang in 2012 (Moran’s I = 0.126 5, Z = 2.193 2, P < 0.05). Local autocorrelation analysis exhibited that high-high clustering areas were mainly distributed in Shufu County, Kashgar City, Jiashi County and Shule County. Spatiotemporal scanning analysis showed that the main clustering area was Jiashi County, and a high incidence period was from 2008 to 2016. Conclusion From 2005 to 2022, the overall incidence of VL exhibited a downward trend in Kashi Prefecture, Xinjiang. The high-risk population consisted mainly of young scattered children, and the northern counties of Kashi were the high endemic areas of VL.

Key words: Visceral leishmaniasis, Epidemiologic characteristics, Spatial autocorrelation, Spatio-temporal scanning analysis, Kashi Prefecture, Xinjiang

中图分类号:

R531.6

买买提江·吾买尔, 亚里昆·买买提依明, 史光忠, 阿衣夏木·克尤木, 赵江山. 2005—2022年新疆喀什地区内脏利什曼病流行病学及时空分布特征[J]. 中国寄生虫学与寄生虫病杂志, 2024, 42(3): 332-339.

MAIMAITIJIANG Umar, YALIKUN Maimaitiyiming, SHI Guangzhong, AYIXIAMU Keyoumu, ZHAO Jiangshan. Epidemiological and spatio-temporal distribution characteristics of visceral leishmaniasis in Kashi Prefecture, Xinjiang, 2005-2022[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2024, 42(3): 332-339.

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年份Year	发病率/10万 Incidence rate/100 000
年份Year	巴楚县 Bachu County	伽师县 Jiashi County	喀什市Kashi City	麦盖提县Maigaiti County	莎车县Shache County	疏附县Shufu County	疏勒县Shule County	塔什库尔干塔吉克自治县 Tajik Autonomous County of Taxkorgan	叶城县 Yecheng County	英吉沙县Yingjisha County	岳普湖县Yuepuhu County	泽普县Zepu County
2005	0.74	2.98	16.1	0	0.75	3.75	2.28	0	0	0.43	0	0
2006	0.97	0	8.36	0.45	1.02	5.29	0	0	0	1.29	0	0
2007	0.71	5.47	7.41	0	0.14	3.62	0.31	0	0	1.68	0	0
2008	2.31	56.75	6.73	0.43	0.28	2.52	1.23	0	0	0.41	2.05	0.48
2009	1.59	50.95	9.67	0.84	0.14	2.97	0.60	0	0	1.20	2.68	0
2010	1.78	10.02	10.31	0.42	0.14	2.67	1.49	0	0	0	1.98	0
2011	0.45	1.10	6.14	0.85	0.14	0.74	0.91	0	0	0.40	0.67	0
2012	0	0.52	2.78	0	0.26	0.32	0.64	0	0	0.38	0.67	0
2013	0	0.51	1.58	0	0	0.64	0	0	0	0	0	0.48
2014	1.77	33.54	1.18	0	0	0	0	0	0	0.74	0.66	0
2015	5.24	89.09	0.97	0	0.13	0	0.31	0	0.21	1.09	1.96	0.47
2016	4.53	31.65	1.13	0.36	0.74	0	0.30	0	0.21	0	4.44	1.38
2017	0.84	1.45	0.37	0	1.23	0.91	0.60	0	0	0.35	0	0.91
2018	0.28	0.24	0.73	0	0	0	0.30	0	0	1.03	0.62	0
2019	0	0.24	0	0	0	0	0	0	0	0	0	0
2020	0	0.23	0.28	0	0	0	0	0	0	0	0	0
2021	0.28	0.24	0	0	0	0	0.30	0	0	0	0	0
2022	0.27	0.24	0	0	0	0	0	0	0	0	0	0

年份 Year	莫兰指数 Moran’s I	标准差 Standard deviation	Z值 Z value	P值 P value
2005	0.083 1	0.089 3	1.974 7	0.054
2006	0.142 5	0.145 7	1.617 8	0.043
2007	0.240 1	0.171 4	1.770 4	0.066
2008	-0.063 4	0.050 8	0.598 8	0.235
2009	-0.039 0	0.064 1	0.865 1	0.127
2010	0.123 8	0.161 5	1.371 8	0.058
2011	0.033 8	0.074 7	1.693 1	0.065
2012	0.126 5	0.100 3	2.193 2	0.042
2013	0.032 8	0.140 0	0.890 9	0.151
2014	-0.082 3	0.042 6	0.244 0	0.305
2015	-0.090 3	0.042 5	0.051 9	0.348
2016	-0.085 8	0.065 7	0.083 8	0.411
2017	-0.186 6	0.187 1	-0.513 7	0.330
2018	0.082 3	0.165 9	1.114 0	0.107
2019	-0.088 3	0.037 7	0.116 2	0.310
2020	0.028 3	0.148 6	0.836 3	0.090
2021	-0.141 5	0.164 6	-0.265 7	0.470
2022	-0.110 7	0.151 3	-0.134 3	0.486

年份Year	高-高聚集区域 High-high cluster area	高-低聚集区域 High-low cluster area	低-低聚集区域 Low-low cluster area	低-高聚集区域 Low-high cluster area
2005	疏附县 Shufu County	喀什市 Kashi City	泽普县 Zepu County	英吉沙县 Yingjisha County
2006	-	-	-	-
2007	疏附县，喀什市 Shufu County, Kashi City	-	泽普县 Zepu County	疏勒县 Shule County
2008	喀什市 Kashi City	-	泽普县，叶城县 Zepu County, Yecheng County	英吉沙县 Yingjisha County
2009	喀什市 Kashi City	-	叶城县 Yecheng County	疏勒县 Shule County
2010	喀什市 Kashi City	-	泽普县，叶城县 Zepu County, Yecheng County	-
2011	伽师县 Jiashi County	喀什市 Kashi City	叶城县 Yecheng County	疏附县 Shufu County
2012	伽师县，喀什市，疏勒县 Jiashi County, Kashi City, Shule County	-	-	疏附县，英吉沙县 Shufu County, Yingjisha County
2013	-	泽普县 Zepu County	-	疏勒县，英吉沙县 Shule County, Yingjisha County
2014	-	-	-	-
2015	-	-	-	麦盖提县 Maigaiti County
2016	-	-	-	麦盖提县 Maigaiti County
2017	-	巴楚县 Bachu County	-	英吉沙县 Yingjisha County
2018	喀什市 Kashi City	巴楚县 Bachu County	-	疏附县，伽师县 Shufu County, Jiashi County
2019	-	伽师县 Jiashi County	-	-
2020	-	-	-	疏附县，英吉沙县，岳普湖县 Shufu County, Yingjisha County, Yuepuhu County
2021	-	巴楚县 Bachu County	-	-
2022	-	巴楚县，伽师县 Bachu County, Jiashi County	-	麦盖提县 Maigaiti County

聚集区类型 Clusters type	聚集时间Cluster time	地区 Region	半径/km Radiue/km	对数似然比Log likelihood ratio	实际报告病例数/例 No. actual reported cases	期望病例数/例 No. expected cases	相对危险度 Relative risk	P值 P value
主要聚集区 Main cluster	2008—2016	伽师县 Jiashi County	0	2 135.75	1 050	78.25	33.83	< 0.01
次级聚集区 Secondary cluster	2005—2011	喀什市 Kashi City	0	169.08	247	61.45	4.54	< 0.05
	2014—2022	叶城县 Yecheng County	0	92.64	2	99.52	0.02	< 0.05
	2014—2022	疏勒县/英吉沙县 Shule County/Yingjisha County	53.53	83.88	15	127.00	0.11	< 0.05
	2014—2022	疏附县 Shufu County	0	56.69	3	67.77	0.04	< 0.05
	2014—2022	麦盖提县 Maigaiti County	0	52.75	1	56.84	0.02	< 0.05
	2006—2014	泽普县 Zepu County	0	35.15	2	42.77	0.05	< 0.05
	2017—2022	巴楚县 Bachu County	0	31.41	6	49.50	0.12	< 0.05

2005—2022年新疆喀什地区内脏利什曼病流行病学及时空分布特征

Epidemiological and spatio-temporal distribution characteristics of visceral leishmaniasis in Kashi Prefecture, Xinjiang, 2005-2022

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[7]	王小军, 蔡玉成, 邹轩, 李辉, 童波波. 2005—2021年甘肃省陇南市内脏利什曼病流行特征[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(5): 579-585.
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[10]	周正斌, 潘改芹, 李元元, 刘琴, 杨丽敏, 李中秋, 马志涛, 张仪, 李石柱. 2021年我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, 2023, 41(2): 149-155.
[11]	王芬芬, 张佩君, 任梦枝, 李道好. 2006—2021年山西省阳泉市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, 2023, 41(2): 228-232.
[12]	郭占景, 张世勇, 刘立. 石家庄市内脏利什曼病复现流行病学调查[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(2): 241-244.
[13]	贾枕枕, 刘洪英, 江琦, 王玲玲, 刘相君. 误诊为血液病的内脏利什曼病1例[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(2): 257-259.
[14]	顾燕, 于琎, 徐策华. 宁夏44年来首例输入性内脏利什曼病病例报道[J]. 中国寄生虫学与寄生虫病杂志, 2023, 41(2): 260-262.
[15]	杨成运, 贺志权, 鲁德领, 钱丹, 刘颖, 李素华, 周瑞敏, 邓艳, 张红卫, 王昊, 赵东阳, 郭万申. 2020年河南省内脏利什曼病病例的流行病学调查[J]. 中国寄生虫学与寄生虫病杂志, 2022, 40(4): 481-486.