2019年我国内脏利什曼病疫情分析

doi:10.12140/j.issn.1000-7423.2020.05.012

摘要/Abstract

摘要：

目的了解2019年全国内脏利什曼病的疫情状况。方法收集2019年国家传染病报告信息管理系统中全国内脏利什曼病病例信息,剔除报告的疑似病例、重复病例以及皮肤利什曼病病例,建立数据库,采用Microsoft Excel 2016软件对内脏利什曼病进行描述性流行病学分析。结果 2019年全国15个省（自治区）的72个县共报告内脏利什曼病166例,其中犬源型病例163例,野生动物源型病例3例,无人源型病例。病例主要分布于山西（52例）、甘肃（43例）和陕西（34例）等3个省,合计报告病例数占全国总报告病例数的77.7%（129/166）。其中31个县属于流行区,共报告本地感染病例124例,其余41个县属于非流行区,共报告输入性病例42例。其中甘肃省舟曲县（16例）、陕西韩城市（16例）、山西阳泉市郊区（13例）和平定县（10例）为主要流行县,报告病例数占全国总报告病例数的33.1%（55/166）。甘肃省镇原县、山西省河津市、河南省龙安区、河北省邢台县为内脏利什曼病复燃流行县,共报告本地感染病例6例。内脏利什曼病发病高峰为4月份,男、女病例数分别为114、52例,性别比为1 ∶ 0.5。农民和学龄前儿童为我国内脏利什曼病高风险人群,报告病例数分别占总报告病例数的47.6%（79/166）和27.1%（45/166)。内脏利什曼病病例主要分布于≥15岁年龄组（占85.7%）,不同流行类型病例的年龄分布明显不同,野生动物源型病例均见于0~2岁学龄前儿童（3例）,犬源型病例主要见于≥15岁农民。结论我国内脏利什曼病呈低流行态势,但流行区范围逐渐扩大,应加强内脏利什曼病监测。

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 2019. Methods Data of visceral leishmaniasis in 2019 were collected from the web-based National Diseases Reporting Information System operated by the Chinese Center for Disease Control and Prevention. After excluding suspected cases, duplicates and cutaneous leishmaniasis cases, a database was established. Descriptive epidemic statistics of visceral leishmaniasis was performed using a Microsoft Excel 2016. Results A total of 166 cases of visceral leishmaniasis were reported in 72 counties of 15 provinces (autonomous regions and municipalities) in 2019, including 163 cases of mountainous zoonotic type, 3 cases of desert zoonotic type and no anthroponotic type. The cases mainly distributed in Shanxi (52 cases), Gansu (43 cases) and Shaanxi Provinces (34 cases), accounting for 77.7% (129/166) of the total reported. A total of 124 local transmitted cases were reported from 31 endemic counties, and 42 imported cases reported 41 non-endemic counties. Zhouqu County of Gansu Province, Hancheng City of Shaanxi Province, Yangquan City suburb and Pingding County of Shanxi Province were the major endemic areas, with 16, 16, 13 and 10 cases reported respectively, accounting for 33.1% (55/166) of the total cases. Zhenyuan County in Gansu Province, Hejin City in Shanxi Province, Long’an District in Henan Province, and Xingtai County in Hebei Province were reemerging endemic counties of visceral leishmaniasis, reporting 6 indigenous cases. The occurrence of visceral leishmaniasis peaked in April, with a male-to-female ratio of 1 ∶ 0.5. Farmers as well as preschoolers are the high-risk populations for visceral leishmaniasis, accounting for 47.6% (79/166) and 27.1% (45/166) of the total cases, respectively. The visceral leishmaniasis cases were mainly distributed in the group aged ≥15 years. However, the age distribution varied significantly due to different types of visceral leishmaniasis, with the desert-type zoonotic cases mainly distributed in age group of 0-2 years of preschoolers and the mountain-type zoonotic cases mainly in farmers aged of ≥15 years. Conclusion Visceral leishmaniasis has a low prevalence in China, whereas the endemic area shows a trend of spreading, thus, it is imperative to strengthen the surveillance for visceral leishmaniasis.

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

中图分类号:

R531.6

周正斌, 李元元, 张仪, 李石柱. 2019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, 2020, 38(5): 602-606.

ZHOU Zheng-bin, LI Yuan-yuan, ZHANG Yi, LI Shi-zhu. Prevalence of visceral leishmaniasis in China in 2019[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2020, 38(5): 602-606.

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流行类型 Epidemiological types	省(自治区) Province (autonomous region)	流行县(区、县级市)（报告病例数） Counties (districts, cities) (No. reported cases)
野生动物源型DT-ZVL	新疆Xinjiang	伽师县 Jiashi County (1), 高昌区 Gaochang District (1), 尉犁县 Yuli County (1)
犬源型MT-ZVL	甘肃Gansu	宕昌县 Dangchang County (6), 迭部县 Diebu County (2), 礼县Lixian County (1), 麦积区 Maiji District (1), 清水县 Qingshui County (1), 文县 Wenxian County (2), 武都区 Wudu District (9), 镇原县 Zhenyuan County（1）,舟曲县 Zhouqu County (16)
	山西Shanxi	大宁县 Daning County (1), 河津市Hejin City (2), 潞州区 Luzhou District (2), 平定县 Pingding County (10), 武乡县 Wuxiang County (4), 乡宁县 Xiangning County (3), 襄汾县 Xiangfen County (4), 阳泉市城区 Urban District of Yangquan (6), 阳泉市郊区 Suburb District of Yangquan (13), 阳泉市矿区 Mining District of Yangquan (4)
	陕西Shaanxi	韩城市 Hancheng City (16), 华州区 Huazhou District (4), 临渭区 Linwei District (5)
	四川 Sichuan	黑水县 Heishui County (2), 九寨沟县 Jiuzhaigou County (1), 理县 Lixian County (1)
	河南 Henan	林州市 Linzhou City(1), 龙安区 Longan District (1)
	河北 Hebei	邢台县 Xingtai County ( 2)

县名 County	流行类型 Epidemiological types	病例数 No. of cases	人口数 Population^a	发病率/1·10 000^-1 Incidence rate/ 1·10 000^-1
陕西韩城市 Hancheng County, Shannxi	MT-ZVL	16	399 400	0.4
甘肃舟曲县 Zhouqu County, Gansu	MT-ZVL	16	135 200	1.2
山西阳泉市郊区 Urban district of Yangquan,Shanxi	MT-ZVL	13	292 300	0.4
山西平定县 Pingding County,Shanxi	MT-ZVL	10	345 700	0.3

特征Features	流行区Endemic area								非流行区 Non-endemic area		合计 Total
	人源型 AVL		野生动物源型 DT-ZVL		犬源型 MT-ZVL		小计 Subtotal		非流行区 Non-endemic area		合计 Total
	病例数No. of cases	构成比/%Proportion/%	病例数No. of cases	构成比/%Proportion/%	病例数No. of cases	构成比/%Proportion/%	病例数No. of cases	构成比/%Proportion/%	病例数No. of cases	构成比/%Proportion/%	病例数No. of cases	构成比/%Proportion/%
年龄组/岁 Age group/years
0~2	0	0	3	100	33	27.3	36	29.0	4	9.5	40	24.1
3~6	0	0	0	0	5	4.1	5	4.0	0	0	5	3.0
7~14	0	0	0	0	8	6.6	8	6.5	2	4.8	10	6.0
≥15	0	0	0	0	75	62.0	75	60.5	36	85.7	111	66.9
职业 Occupation
学龄前儿童 Preschooler	0	0	3	3/3	38	31.4	41	33.1	4	9.5	45	27.1
学生Students	0	0	0	0	10	8.3	10	8.1	2	4.8	12	7.2
农民Farmers	0	0	0	0	55	45.5	55	44.4	24	57.1	79	47.6
工人Workers	0	0	0	0	3	2.5	3	2.4	3	7.1	6	3.6
商务服务 Business services	0	0	0	0	1	0.8	1	0.8	0	0	1	0.6
家务及待业 House work and unemployed	0	0	0	0	7	5.8	7	5.6	4	9.5	11	6.6
其他Others	0	0	0	0	7	5.8	7	5.6	5	11.9	12	7.2
性别Gender
男Male	0	0	3	100	83	68.6	86	69.4	28	66.7	114	68.7
女Female	0	0	0	0	38	31.4	38	30.6	14	33.3	52	31.3
合计Total	0	0	3	100	121	100	124	100	42	100	166	100