2023年我国内脏利什曼病疫情分析

doi:10.12140/j.issn.1000-7423.2024.05.001

中国寄生虫学与寄生虫病杂志 ›› 2024, Vol. 42 ›› Issue (5): 559-565.doi: 10.12140/j.issn.1000-7423.2024.05.001

2023年我国内脏利什曼病疫情分析

周正斌¹(), 李元元¹, 李中秋¹, 杨丽敏¹, 刘琴¹, 张仪¹^,²^,^*(), 陈军虎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全球健康学院，上海 200025

收稿日期:2024-09-25 修回日期:2024-10-07 出版日期:2024-10-30 发布日期:2024-10-25
通讯作者: * 张仪（1966—），女，硕士，研究员，从事寄生虫与媒介的研究。E-mail：zhangyi@nipd.chinacdc.cn;
陈军虎（1978—），男，博士，研究员，从事重要媒传寄生虫感染与宿主免疫、诊断、疫苗研究。E-mail：chenjh@nipd.chinacdc.cn
作者简介:周正斌（1983—），男，硕士，副研究员，从事内脏利什曼病防治研究。E-mail：zhouzb@nipd.chinacdc.cn
基金资助:
国家重点研发计划(2023YFC2300804);国家重点研发计划(2023YFC2300804)

Prevalence of visceral leishmaniasis in China in 2023

ZHOU Zhengbin¹(), LI Yuanyuan¹, LI Zhongqiu¹, YANG Limin¹, LIU Qin¹, ZHANG Yi¹^,²^,^*(), CHEN Junhu¹^,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 Collaborating 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:2024-09-25 Revised:2024-10-07 Online:2024-10-30 Published:2024-10-25
Contact: * E-mail:zhangyi@nipd.chinacdc.cn;
chenjh@nipd.chinacdc.cn
Supported by:
National Key Research and Development Program(2023YFC2300804);National Key Research and Development Program(2023YFC2300804)

摘要/Abstract

摘要：

目的了解2023年全国内脏利什曼病疫情状况，为制定防治策略和措施提供科学依据。方法收集2023年中国疾病预防控制中心传染病报告信息管理系统报告的全国内脏利什曼病病例信息，剔除疑似病例、重复病例和皮肤利什曼病病例，建立数据库。采用Microsoft Excel 2016软件对内脏利什曼病三间分布进行描述性流行病学分析。结果 2023年全国15个省（自治区、直辖市）的125个县共报告内脏利什曼病病例299例，发病率为0.02/10万，较2022年上升25.1%；其中犬源型（山丘型）内脏利什曼病病例237例，野生动物源型（荒漠型）内脏利什曼病病例7例，人源型内脏利什曼病病例1例，非流行区输入性病例54例。报告病例主要分布于山西（114例）、河南（54例）和陕西（38例）等3个省，合计占全国报告病例总数的68.9%（206/299）。125个县中，74个县属于流行区，共报告本地感染病例245例；其余51个县属于非流行区，共报告输入性病例54例。74个流行县中，山西省平定县、阳泉市郊区、襄汾县，河北省井陉县，陕西省华州区，河南省林州市和新安县等7个县为内脏利什曼病主要流行县，分别报告病例24、16、10、13、12、12和10例，合计报告病例占全国总病例数的32.4%（97/299）。山西省洪洞、黎城、临县、石楼、五台，河北省曲阳、阜平、涞源、平山、涉县、唐县、易县，河南省嵩县、禹州，甘肃省成县、康县，北京市延庆和陕西省澄城等18个县为内脏利什曼病复燃流行县，共报告本地感染病例23例。内脏利什曼病发病高峰为3月。男女病例比为1:0.4。农民占全部病例数的57.2%（171/299）。病例主要分布于45~74岁年龄段 (占64.5%)。结论我国内脏利什曼病呈低度流行态势，但发病率呈快速上升趋势，流行区范围逐渐扩大，农民是我国内脏利什曼病高风险人群，应加强对内脏利什曼病的监测和防控。

关键词: 内脏利什曼病, 黑热病, 疫情, 分布, 中国

Abstract:

Objective To understand the epidemic situation of visceral leishmaniasis (VL) in China in 2023 to provide scientific evidence for formulating prevention and control strategies. Methods Data on VL cases reported in 2023 was collected from the web-based National Diseases Reporting Information System (NDRIS) operated by the Chinese Center for Disease Control and Prevention. From the collected information, suspected cases, duplicate cases and cutaneous leishmaniasis cases were excluded to establish a database. Descriptive epidemiological analysis of the three-dimensional distribution of VL was conducted using Microsoft Excel 2016 software. Results A total of 299 VL cases were reported in 125 counties across 15 provinces (autonomous regions and municipalities) in 2023, with an incidence rate of 0.02/100 000, showing a 25.1% increase from the year 2022. Among these, 237 cases were of mountain-type zoonotic VL (MT-VL), 7 cases were of desert-type zoonotic VL (DT-ZVL), 1 case was of anthroponotic VL (AVL), and 54 cases were imported cases from non-endemic regions. The reported cases were mainly distributed in Shanxi (114 cases), Henan (54 cases) and Shaanxi (38 cases) provinces, together accounting for 68.9% (206/299) of the total reported cases in China. Of the 125 counties, 74 were endemic counties, reporting 245 locally acquired cases, while the remaining 51 were non-endemic counties, reporting 54 imported cases. Among the 74 endemic provinces, seven counties including Pingding County, Suburb District of Yangquan, Xiangfen County in Shanxi Province, Jingxing County of Hebei Province, Huazhou District in Shaanxi Province, Linzhou City and Xin’an County of Henan Province were the major endemic counties. These counties reported 24, 16, 10, 13, 12, 12 and 10 VL cases, respectively, accounting for 32.4% (97/299) of the total cases reported nationwide. Eighteen counties, including Hongdong, Licheng, Linxian, Shilou, and Wutai counties in Shanxi Province; Quyang, Fuping, Laiyuan, Pingshan, Shexian, Tangxian, and Yixian counties in Hebei Province; Songxian and Yuzhou in Henan Province; Chengxian and Kangxian counties in Gansu Province; Yanqing District in Beijing; and Chengcheng County in Shaanxi Province, were new reemergence VL endemic counties, reporting 23 locally acquired cases. The peak incidence of VL occurred in March. The ratio of male to female cases was 1:0.4. Farmers accounted for 57.2% (171/299) of the total cases. The age distribution of VL cases was predominantly in the 45-74 years old group (64.5%). Conclusion VL in China exhibits a low prevalence but the incidence showed a rapid increasing trend, and the endemic area was in expanding. Farmers are recognized as the high-risk population for visceral leishmaniasis. It is imperative to strengthen the surveillance and prevention of visceral leishmaniasis.

Key words: Visceral leishmaniasis, Kala-azar, Epidemic status, Distribution, China

中图分类号:

R531.6

周正斌, 李元元, 李中秋, 杨丽敏, 刘琴, 张仪, 陈军虎, 李石柱. 2023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, 2024, 42(5): 559-565.

ZHOU Zhengbin, LI Yuanyuan, LI Zhongqiu, YANG Limin, LIU Qin, ZHANG Yi, CHEN Junhu, LI Shizhu. Prevalence of visceral leishmaniasis in China in 2023[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2024, 42(5): 559-565.

图/表 5

表1

2023年全国流行区内脏利什曼病报告病例地区分布及其流行区类型

流行区类型 Types of endemic area	省级行政区 Provincial-level administrative division	流行县（区、县级市）（病例数） Endemic counties (District, City) （No. case）
DT-ZVL	新疆 Xinjiang	库尔勒市 Korla City (2)，昌吉市 Changji City (1)，伽师县 Jiashi County (1)，民丰县 Minfeng County (1)，焉耆回族自治县 Yanqi Hui Autonomous County (1)
DT-ZVL	甘肃 Gansu	敦煌市 Dunhuang City (1)
AVL	新疆 Xinjiang	阿图什市 Atushi City (1)
MT-ZVL	甘肃 Gansu	舟曲县 Zhouqu County (5)，武都区 Wudu District (3)，成县 Chengxian County (2)，迭部县 Diebu County (2)，礼县 Lixian County (2)，麦积区 Maiji District (2)，文县 Wenxian County (2)，环县 Huanxian County (1)，康县 Kangxian County (1)，西和县 Xihe County (1)，永靖县 Yongjing County (1)
	山西 Shanxi	平定县 Pingding County (24)，阳泉市郊区 Suburb District of Yangquan (16)，襄汾县 Xiangyuan County (10)，阳泉市矿区 Mining District of Yangquan (9)，盂县 Yuxian County (8)，曲沃县 Quwo County (7)，乡宁县 Xiangning County (5)，高平市 Gaoping City (4)，潞城区 Lucheng County (4)，浮山县 Fushan County (3)，阳泉市城区 Urban District of Yangquan (2)，绛县 Jiangxian County(2)，武乡县Wuxiang County (2)，尧都区Yaodu District (2)，大宁县 Daning County (1)，洪洞县 Hongdong County (1)，侯马市 Houma City(1)，黎城县 Licheng County (1)，临县 Linxian County (1)，石楼县 Shilou County (1)，五台县 Wutai County (1)，昔阳县 Xiyang County (1)，襄垣县 Xiangyuan county (1)，翼城县 Yicheng County (1)
	陕西 Shaanxi	华州区 Huazhou District (12)，韩城市 Hancheng City (7)，临渭区 Linwei District (3)，宝塔区 Baota District (1)，澄城县 Chengcheng County (1)，延长县 Yanchang County (1)
	四川 Sichuan	黑水县 Heishui county (1)，九寨沟县 Jiuzhaigou County (1)
	河南 Henan	林州市 Linzhou City (12)，新安县 Xinan County (10)，登封市 Dengfeng City (9)，巩义市 Gongyi City (7)，荥阳市 Xingyang City (3)，新密市 Xinmi City (2)，龙安区 Longan District (1)，孟津区 Mengjin District (2)，嵩县 Songxian County (1)，偃师区 Yanshi District (1)，禹州市 Yuzhou City (1)
	河北 Hebei	井陉县 Jingxing County (13)，曲阳县 Quyang County (5)，井陉矿区 Mining District of Jingxing (3)，阜平县 Fuping County (1)，涞源县 Laiyuan County (1)，临城县 Lincheng County(1)，平山县 Pingshan County (1)，涉县 Shexian County (1)，唐县 Tangxian County (1)，信都区 Xindu District (1)，易县Yixian County (1)，赞皇县 Zanhuang County (1)
	北京 Beijing	延庆区 Yanqing District (1)

表1

表2

图1

图2

表3

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县 County	流行类型 Endemic type	病例数 No. case	人口数^a Population^a	发病率（1/10 000） Incidence rate (1/10 000)
山西省平定县 Pingding County, Shanxi	MT-ZVL	24	306 200	0.8
山西省阳泉市郊区 Urban District of Yangquan, Shanxi	MT-ZVL	16	274 500	0.6
山西省襄汾县 Xiangfen County, Shanxi	MT-ZVL	10	418 400	0.2
河北省井陉县 Jingxing County, Hebei	MT-ZVL	13	251 000	0.5
陕西省华州区 Huazhou District, Shaanxi	MT-ZVL	12	264 500	0.5
河南省林州市 Linzhou City, Henan	MT-ZVL	12	815 700	0.2
河南省新安县 Xin’an County, Henan	MT-ZVL	10	474 000	0.2

特征 Feature	流行区 Endemic region								非流行区 Non-endemic region		合计 Total
	AVL		DT-ZVL		MT-ZVL		小计 Subtotal		非流行区 Non-endemic region		合计 Total
	病例数 No. case	构成比/% Composition rate/%	病例数 No. case	构成比/% Composition rate/%	病例数 No. case	构成比/% Composition rate/%	病例数 No. case	构成比/% Composition rate/%	病例数 No. case	构成比/% Composition rate/%	病例数 No. case	构成比/% Composition rate/%
职业 Occupation
婴幼儿 Infant and young children	0	0	2	28.60	26	11.00	28	11.40	7	13.00	35	11.70
学生 Student	0	0	0	0	9	3.80	9	3.70	2	3.70	11	3.70
农民 Farmer	1	100	2	28.60	141	59.50	144	58.80	27	50.00	171	57.20
工人 Worker	0	0	0	0	11	4.60	11	4.50	1	1.90	12	4.00
商务服务 Business service	0	0	0	0	2	0.80	2	0.80	1	1.90	3	1.00
家务及待业 Household duties and unemployed	0	0	1	14.30	22	9.30	23	9.40	9	16.70	32	10.70
离退人员 Retired personnel	0	0	1	14.30	10	4.20	11	4.50	1	1.90	12	4.00
其他 Others	0	0	1	14.30	16	6.80	17	6.90	6	11.10	23	7.70
性别 Gender
男 Male	1	100	5	71.40	170	71.70	176	71.80	42	77.80	218	72.90
女 Female	0	0	2	28.60	67	28.30	69	28.20	12	22.20	81	27.10
合计 Total	1	100	7	100	237	100	245	100	54	100	299	100

2023年我国内脏利什曼病疫情分析

Prevalence of visceral leishmaniasis in China in 2023

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