2013—2022年临汾市内脏利什曼病流行特征分析

doi:10.12140/j.issn.1000-7423.2024.06.005

摘要/Abstract

摘要：

目的分析2013—2022年山西省临汾市内脏利什曼病流行病学特征，为内脏利什曼病防控提供科学依据。方法收集中国传染病报告信息管理系统中2013年1月1日—2022年12月31日山西省临汾市内脏利什曼病报告病例信息，采用描述性流行病学方法，分析内脏利什曼病病例的发病时间、区域分布、年龄和职业等特征。2023年7月在洪洞县、吉县、霍州市用诱蛉灯法对白蛉密度开展监测并进行分类鉴定。结果 2013—2022年临汾市共报告内脏利什曼病病例78例，无死亡病例，年均报告发病率为0.199 6/10万，报告发病率呈逐年上升趋势（χ² = 78.000，P < 0.01）。其中2013—2016年共报告3例，2017年后逐年增多，2021年和2022年分别为19例、28例。各月份均有病例报告，报告病例数最多为4月（14例），占总病例数的17.95%（14/78）；最少为10月，为1例。共10个县（市、区）有内脏利什曼病本地感染病例报告，前3位的分别是襄汾县（20例）、曲沃县（20例）和乡宁县（18例）。报告病例的县数由2013年的1个增加到2022年的8个。78例病例中男性57例、女性21例，男女性别比为2.71∶1；报告病例年龄以0~9岁组（23例）和60~69岁组（19例）为主，各年龄组报告病例数之间的差异有统计学意义（χ² = 20.919，P < 0.01）；职业以农民（41例）和散居儿童（22例）为主；外省（市）诊断42例（占53.85%），临汾市诊断36例（占46.15%）。共捕获2 299只雌性白蛉，经鉴定均为中华白蛉，平均密度为1.58只/（灯•夜)。结论自2017年以来，临汾市疫情呈上升趋势，流行区范围扩大，应加强防控意识和防控力度，控制内脏利什曼病的流行。

关键词: 内脏利什曼病, 流行特征, 媒介白蛉, 防治措施

Abstract:

Objective To analyze the epidemiological characteristics of visceral leishmaniasis in Linfen City, Shanxi Province from 2013 to 2022, so as to provide insights into prevention and control of visceral leishmaniasis. Methods All data pertaining to reported visceral leishmaniasis cases in Linfen City, Shanxi Province from January 1, 2013 to December 31, 2022 were collected from the Infectious Diseases Report Information Management System of China Disease Prevention and Control Information System. The temporal, regional, age and occupation distributions of reported visceral leishmaniasis cases were analyzed using a descriptive epidemiological method. In addition, the sandfly density was monitored using sandfly light traps in Hongdong County, Jixian County and Huozhou City in July 2023, and the sandfly species was identified. Results A total of 78 visceral leishmaniasis cases were reported in Linfen City from 2013 to 2022, with no deaths, and the annual average incidence was 0.199 6/10⁵, which appeared a tendency towards a rise over years (χ² = 78.000, P < 0.01). Among them, a total of 3 cases were reported from 2013 to 2016, and the number has increased year by year since 2017. In 2021 and 2022, there were 19 and 28 cases respectively. Visceral leishmaniasis cases were reported in each month, with the highest number in April (14 cases, 17.95% of total cases), and the lowest number in October (1 case). Local cases of visceral leishmaniasis were reported in 10 counties (cities, districts) of Linfen City, and the three counties with the highest numbers of local cases included Xiangfen County (20 cases), Quwo County (20 cases), and Xiangning County (18 cases). The number of counties reporting cases has increased from 1 in 2013 to 8 in 2022. Among the 78 reported visceral leishmaniasis cases, there were 57 men and 21 women, with a male to female ratio of 2.71∶1, and the reported cases were predominantly aged 0 to 9 years (23 cases) and 60 to 69 years (19 cases), with a significant difference in the age distribution (χ² = 20.919, P < 0.01). Farmers (41 cases) and diaspora children (22 cases) were predominant occupations, and there were 42 cases (53.85%) diagnosed in other provinces (municipalities), and 36 cases (46.15%) diagnosed in Linfen City. A total of 2 299 female sandflies were captured and all were identified as Phlebotomus chinensis, with an average density of 1.58 sandflies/(lamp•night). Conclusion The epidemics of visceral leishmaniasis have appeared a tendency towards a rise in Linfen City since 2017, with expansion of epidemic areas and severe epidemics. Improved control awareness and intensified control efforts are recommended to control the transmission of visceral leishmaniasis.

Key words: Visceral leishmaniasis, Epidemiological characteristic, Vector sandfly, Control measure

中图分类号:

R531.6

邵宏莉, 冯美娟, 黄丽, 史临爱, 梁红云, 张建, 张重辉. 2013—2022年临汾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, 2024, 42(6): 721-725.

SHAO Hongli, FENG Meijuan, HUANG Li, SHI Lin’ai, LIANG Hongyun, ZHANG Jian, ZHANG Chonghui. Epidemiological characteristics of visceral leishmaniasis in Linfen City from 2013 to 2022[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2024, 42(6): 721-725.

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县（市、区） County (city, district)	病例数/例 No. case	构成比/% Proportion/%
襄汾县 Xiangfen County	20	25.64
曲沃县 Quwo County	20	25.64
乡宁县 Xiangning County	18	23.08
大宁县 Daining County	7	8.97
浮山县 Fushan County	5	6.41
尧都区 Yaodu District	4	5.13
汾西县 Fenxi County	1	1.28
侯马市 Houma City	1	1.28
吉县 Ji County	1	1.28
翼城县 Yicheng County	1	1.28
合计 Total	78	100

年龄组 Age group	病例数/例 No. case	性别 Sex		职业 Occupation
年龄组 Age group	病例数/例 No. case	男Male	女 Female	农民 Farmer	散居儿童 Scattered child	家务及待业 Housework and unemployment	学生 Student	工人 Worker	离退人员 Retirees personnel	其他 Others
0~9	23	11	12	0	22	0	1	0	0	0
10~19	2	0	2	0	0	0	2	0	0	0
20~29	3	2	2	1	0	1	0	1	0	0
30~39	4	3	2	1	0	0	1	1	0	1
40~49	9	9	0	6	0	0	0	1	0	2
50~59	12	11	1	10	0	2	0	0	0	0
60~69	19	15	4	19	0	0	0	0	0	0
≥ 70	6	6	0	4	0	0	0	1	1	0
合计 Total	78	57	21	41	22	3	4	4	1	3

监测点 Monitoring site	捕获中华白蛉雌蛉数/只） Number of female P. sinensis captured/individual	布灯数/台 Number of lights/lamp	监测时常/夜 Monitoring time/night	白蛉密度/只·（灯·夜）^-1 Phlebotomus density/individuals·(lamp·night)^-1
洪洞 Hongdong	21	18	9	0.13
吉县 Ji County	2 259	18	9	13.94
霍州 Huozhou	19	18	9	0.12
合计 Total	2 299	54	27	1.58