2021年我国内脏利什曼病疫情分析

doi:10.12140/j.issn.1000-7423.2023.02.004

中国寄生虫学与寄生虫病杂志 ›› 2023, Vol. 41 ›› Issue (2): 149-155.doi: 10.12140/j.issn.1000-7423.2023.02.004

2021年我国内脏利什曼病疫情分析

周正斌¹(), 潘改芹², 李元元¹, 刘琴¹, 杨丽敏¹, 李中秋¹, 马志涛¹, 张仪¹^,³^,^*(), 李石柱¹^,³

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），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，国家级热带病国际联合研究中心，上海 200025
2 聊城市人民医院，山东聊城 252000
3 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:2023-02-15 修回日期:2023-03-28 出版日期:2023-04-24 发布日期:2023-04-24
通讯作者: 张仪
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(2021YFC2300800);国家重点研发计划(2021YFC2300804);上海市青年科技英才扬帆计划(21YF1452200)

Prevalence of visceral leishmaniasis in China in 2021

ZHOU Zhengbin¹(), PAN Gaiqin², LI Yuanyuan¹, LIU Qin¹, YANG Limin¹, LI Zhongqiu¹, MA Zhitao¹, ZHANG Yi¹^,³^,^*(), LI Shizhu¹^,³

1 National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research); NHC Key Laboratory of Parasite and Vector Biology; WHO Collaborating Centre for Tropical Diseases; National Center for International Research on Tropical Diseases, Shanghai 200025, China
2 Liaocheng People’s Hospital, Liaocheng 252000, Shandong, China
3 School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received:2023-02-15 Revised:2023-03-28 Online:2023-04-24 Published:2023-04-24
Contact: ZHANG Yi
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： 目的分析2021年全国内脏利什曼病的疫情状况，为制订防治策略提供科学依据。方法收集2021年国家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三间分布进行描述性流行病学分析。结果 2021年全国14个省（自治区、直辖市）的81个县共报告内脏利什曼病230例，其中犬源型流行区病例180例，野生动物源型流行区病例4例，人源型流行区病例1例，非流行区输入性病例45例。病例主要分布于山西（127例）、陕西（35例）和甘肃（20例）等3个省，报告病例数合计占全国报告病例总数的79.1%（182/230）。全国44个县属于流行区，共报告本地感染病例185例；其余37个县属于非流行区，共报告输入性病例45例。其中，山西省平定县（33例）、阳泉市郊区（29例）、阳泉市矿区（18例）、襄汾县（10例）和陕西省韩城市（11例）为主要流行县，报告病例数占全国总病例数的43.9%（101/230）。内脏利什曼病复燃流行县主要集中在甘肃省（秦州区、西和县）、山西省（尧都区、和顺县、陵川县、沁县、屯留区、昔阳县）和河南省（新安县、新密市），共报告本地感染病例10例。甘肃省玉门市为新发流行县，报告本地感染病例1例。内脏利什曼病发病高峰为4月份。男女病例比为1∶0.4。农民和婴幼儿报告病例数分别占总报告病例数的47.4%（109/230）和24.8%（57/230)；≥ 15岁年龄组占73.5%（169/230）。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，应加强监测和防控。

关键词: 内脏利什曼病, 疫情, 分布, 中国

Abstract: Objective To analyze the epidemic situation of visceral leishmaniasis in China in 2021 and to provide the scientific basis for formulating the prevention and control strategies. Methods Data on visceral leishmaniasis in 2021 was collected from the web-based National Diseases Reporting Information System. After excluding suspected cases, duplicates and cutaneous leishmaniasis cases, a database was established， based on which the distribution of visceral leishmaniasis was analyzed using descriptive epidemiological method with Microsoft Excel version 2016. Results A total of 230 cases of visceral leishmaniasis were reported in 14 provinces (autonomous regions and municipalities) in 2021, among them 180 cases were reported from mountain-type zoonotic visceral leishmaniasis endemic areas, 4 cases from desert-type zoonotic visceral leishmaniasis endemic areas, 1 case from anthroponotic visceral leishmaniasis endemic areas, and 45 cases were imported from non-endemic areas. These cases were mainly distributed in Shanxi (127 cases), Shaanxi (35 cases) and Gansu (20 cases), the total reported accounting for 79.1%(182/230) of the overall total in China. A total of 185 local transmitted cases were reported from 44 endemic counties; other 37 counties were of non-endemic areas, reporting 45 imported cases. The Pingding County, outer suburbs of Yangquan City, mining district of Yangquan City, Hancheng City, and Xiangfen County were the major endemic counties, with 33, 29, 18, 11 and 10 cases reported, respectively, the total accounting for 43.9% (101/230) of the overall total cases in China. In 2021, recurrence endemic counties of visceral leishmaniasis were mainly concentrated in Gansu Province (Qinzhou District, Xihe County), Shanxi Province (Yaodu District, Heshun County, Lingchuan County, Qin County, Tunliu District, Xiyang County) and Henan Province (Xin’an County, Xinmi City), with a total of 10 local cases reported. Yumen City in Gansu Province was the newly emerging endemic county with 1 local case reported. The peak incidence occurred in April. The ratio of male to female cases was 1:0.4. The number of reported cases in peasants and infants accounted for 47.4% (109/230) and 24.8% (57/230) of the total cases, respectively. The reported cases at age of ≥ 15 accounted for 73.5% (169/230). Conclusion Visceral leishmaniasis presents a low prevalence in China, whereas, the range of endemic area is gradually expanding. Thus, surveillance and control activities should be strengthened.

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

中图分类号:

R531.6

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.

ZHOU Zhengbin, PAN Gaiqin, LI Yuanyuan, LIU Qin, YANG Limin, LI Zhongqiu, MA Zhitao, ZHANG Yi, LI Shizhu. Prevalence of visceral leishmaniasis in China in 2021[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2023, 41(2): 149-155.

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参考文献 29

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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/例） Endemic counties (districts, cities) (No. reported case)
野生动物源型DT-ZVL	新疆 Xinjiang	伽师县 Jiashi County (1)，巴楚县 Bachu County (1)，图木舒克市 Tumshuk City (1)
野生动物源型DT-ZVL	甘肃 Gansu	玉门市 Yumen City (1)
人源型AVL	新疆 Xinjiang	疏勒县 Shule County (1)
犬源型 MT-ZVL	甘肃 Gansu	武都区 Wudu District (8)，舟曲县 Zhouqu County (4)，礼县 Lixian County (1)，麦积区 Maiji District (1)，文县 Wenxian County (1)，秦州区 Qinzhou District (1)，庆城县 Qingcheng County (1)，镇原县 Zhenyuan County (1)，西和县 Xihe County (1)
	山西 Shanxi	平定县 Pingding County (33)，阳泉市郊区 Outer suburbs of Yangquan City (29)，阳泉市矿区 Mining district of Yangquan City (18)，襄汾县 Xiangfen County (10)，阳泉市城区 Urban district of Yangquan City (8)，曲沃县 Quwo County (5)，盂县 Yuxian County (4)，襄垣县 Xiangyuan County (4)，河津市 Hejin City (3)，尧都区 Yaodu District (1)，潞州区 Luzhou District (1)，武乡县 Wuxiang County (1)，乡宁县 Xiangning County (1)，和顺县 Heshun County (1)，陵川县 Lingchuan County (1)，沁县 Qinxian County (1)，屯留区 Tunliu District (1)，昔阳县 Xiyang County (1)，垣曲县 Yuanqu County (1)
	陕西 Shaanxi	韩城市 Hancheng City (11)，华州区 Huazhou District (5)，延川县Yanchuan County (1)，延长县Yanchang County (1)
	四川 Sichuan	九寨沟县 Jiuzhaigou County (2)
	河南 Henan	林州市 Linzhou City (6)，巩义市 Gongyi City (2)，荥阳市 Xingyang City (2)，新安县 Xin’an County (1)，新密市 Xinmi City (1)
	河北 Hebei	井陉县 Jingxing County (5)

县 County	流行类型 Epidemiological type	报告病例数 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	MT-ZVL	33	303 600	1.1
山西阳泉市郊区 Outer suburbs of Yangquan City, Shanxi	MT-ZVL	28	275 700	1.0
山西阳泉市矿区 Mining dstrict of Yangquan City, Shanxi	MT-ZVL	18	228 000	0.8
陕西韩城市 Hancheng City, Shaanxi	MT-ZVL	11	392 500	0.3
山西襄汾县 Xiangfen County, Shanxi	MT-ZVL	10	421 900	0.2

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
	报告病例数 No. reported case	构成比/% Composition rate/%	报告病例数 No. reported case	构成比/% Composition rate/%	报告病例数 No. reported case	构成比/% Composition rate/%	报告病例数 No. reported case	构成比/% Composition rate/%	报告病例数 No. reported case	构成比/% Composition rate/%	报告病例数 No. reported case	构成比/% Composition rate/%
年龄组/岁 Age group/year
0~2	0	0	2	2/4	36	020.0	38	020.5	4	008.9	42	018.3
3~6	0	0	0	0	4	002.2	4	002.2	0	000.0	4	001.7
7~14	0	0	0	0	14	007.8	14	007.6	1	002.2	15	006.5
≥ 15	1	1/1	2	2/4	126	070.0	129	069.7	40	088.9	169	073.5
职业 Occupation
婴幼儿 Infants and young children	0	0	2	2/4	50	027.8	52	028.1	5	011.1	57	024.8
学生 Students	0	0	0	0	5	002.8	5	002.7	1	002.2	6	002.6
农民 Peasants	1	1/1	2	2/4	81	045.0	84	045.4	25	055.6	109	047.4
工人 Workers	0	0	0	0	0	000.0	0	000.0	1	002.2	1	000.4
商务服务 Business services	0	0	0	0	13	007.2	13	007.0	5	011.1	18	007.8
家务及待业 House work and unemployed	0	0	0	0	12	006.7	12	006.5	4	008.9	16	007.0
离退人员 Retired personnel	0	0	0	0	11	006.1	11	005.9	2	004.4	13	005.7
其他 Others	0	0	0	0	8	004.4	8	004.3	2	004.4	10	004.3
性别 Gender
男 Male	1	1/1	3	3/4	120	066.7	124	067.0	35	077.8	159	069.1
女 Female	0	0	1	1/4	60	033.3	61	033.0	10	022.2	71	030.9
合计 Total	1	1/1	4	4/4	180	100.0	185	100.0	45	100.0	230	100.0

2021年我国内脏利什曼病疫情分析

Prevalence of visceral leishmaniasis in China in 2021

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