石家庄市内脏利什曼病复现流行病学调查

doi:10.12140/j.issn.1000-7423.2023.02.020

摘要/Abstract

摘要：

从国家传染病报告信息管理系统中收集2019—2021年石家庄市报告的内脏利什曼病病例个案调查资料，采集病例所在村全部犬只的血样，同时采集报告病例家人以及以病例住处为中心、半径100 m以内邻居的静脉血样，用rk39免疫层析试纸检测血清抗利什曼原虫抗体。于2019—2021年5—9月，在病例所在庭院利用灯诱法捕获白蛉。2019—2021年，石家庄市共报告内脏利什曼病病例8例（2019年1例，2021年7例），井陉县6例，藁城区和鹿泉区各1例。男性4例，女性4例。年龄最小的1岁，最大的71岁；≤ 2岁2例，30~49岁1例，≥ 50岁5例；幼儿2例，农民5例，干部1例。7例为本地感染病例，1例为外省（山西省）输入病例。共检测犬400只，利什曼原虫抗体阳性率为11.0%（44/400）。井陉县6个村犬抗利什曼原虫抗体阳性率为6.4%~8/20（χ² = 14.76，P < 0.05），鹿泉区石井村和藁城区西辛庄村犬抗利什曼原虫抗体阳性率为1.2%（2/172）和0（0/31）；井陉县与鹿泉区和藁城区犬抗利什曼原虫抗体阳性率差异有统计学意义（χ² = 32.55、8.10，P < 0.05）。井陉县和藁城区分别采集重点人员血样309份和4份，抗利什曼原虫抗体均为阴性；鹿泉区采集重点人员血118份，利什曼原虫抗体阳性1份，阳性率为0.9%（1/118）。井陉县捕获到中华白蛉4只，鹿泉区、藁城区均未捕获到白蛉。井陉县内脏利什曼病传播风险较高，需积极采取防控措施防止疫情的进一步扩散。

关键词: 内脏利什曼病, 复现, 流行病学调查分析, 石家庄市

Abstract:

Case investigation data of visceral leishmaniasis reported in Shijiazhuang City from 2019 to 2021 was collected from the national infectious disease reporting and information management system. Blood samples were collected from all dogs in the villages where the patients reside. Meantime, venous blood samples were collected from the patient’s family members and neighbours within an area of 100 meters radius centered on the patient’s residence. The rk39 immunochromatographic test strip was used to detect serum anti-Leishmania antibodies. From May to September, sandflies were captured using light traps in the courtyards where the patients reside. A total of 8 visceral leishmaniasis cases were reported in Shijiazhuang City from 2019 to 2021 (1 case in 2019, 7 cases in 2021), 6 cases in Jingxing County, 1 case in Gaocheng District and 1 case in Luquan District respectively. There were 4 males and 4 females. Their age ranged from 1 year old to 71 years old, among which there was 2 cases aged ≤ 2 years, 1 case aged 30-49 years, 5 cases aged ≥ 50 years. There were 2 young children, 5 farmers and 1 cadre. Seven cases were infected in local counties and 1 case was imported from another province (Shanxi Province). A total of 400 dogs were tested, and the positive rate of anti-Leishmania antibody was 11.0% (44/400). The positive rates of anti-Leishmania antibody in dogs from 6 villages of Jingxing County ranged from 6.4% to 8/20 (χ² = 14.76, P < 0.05), and were 1.2% (2/172) and 0 (0/31) in dogs from Shijing Village of Luquan District and Xixinzhuang Village of Gaocheng District, respectively, with statistically significant differences between Jingxing County and Luquan District or Gaocheng District (χ² = 32.55, 8.10; P < 0.05). The 309 and 4 blood samples collected from the key personnel in Jingxing County and Gaocheng District respectively were negative for anti-Leishmania antibody, 118 blood samples collected from key personnel in Luquan District, among which 1 blood sample was positive, and the positive rate is 0.9% (1/118). Four Phlebotomus chinensis were captured in Jingxing County, while no sandflies was captured in Luquan District and Gaocheng District. There was a high risk of the spread of visceral leishmaniasis in Jingxing County. Active prevention and control measures were needed to prevent further spread.

Key words: Visceral leishmania, Recurrence, Epidemiological investigation and analsis, Shijiazhuang City

中图分类号:

R531.6

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.

GUO Zhanjing, ZHANG Shiyong, LIU Li. Epidemiological investigation on the recurrence of visceral leishmaniasis in Shijiazhuang City[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2023, 41(2): 241-244.

图/表 1

参考文献 14

[1]	Li LJ, Ren H. Infectious diseases[M]. 9th ed. Beijing: People’s Medical Publishing House, 2018: 274. (in Chinese)
	(李兰娟, 任红. 传染病学[M]. 9版. 北京: 人民卫生出版社, 2018: 274.)
[2]	Al-Salem W, Herricks JR, Hotez PJ. A review of visceral leishmaniasis during the conflict in South Sudan and the consequences for East African countries[J]. Parasit Vectors, 2016, 9(1): 460.
[3]	World Health Organization. Control of the leishmaniasis[R]. Geneva: World Health Organization, 2010: 5-12.
[4]	Guan LR, Wu ZX. Historical experience in the elimination of visceral leishmaniasis in the plain region of Eastern and Central China[J]. Infect Dis Poverty, 2014, 3: 1-12.
[5]	Zhao YZ, Jiang D, Ding FY, et al. Recurrence and driving factors of visceral leishmaniasis in central China[J]. Int J Environ Res Public Health, 2021, 18(18): 9535.
[6]	Guan Z, Chen C, Huang CY, et al. Epidemiological features and spatial-temporal distribution of visceral leishmaniasis in mainland China: a population-based surveillance study from 2004 to 2019[J]. Parasit Vectors, 2021, 14(1): 517.
[7]	Luo ZW, Zhou ZB, Gong YF, et al. Current status and challenges of visceral leishmaniasis in China[J]. Chin J Parasitol Parasit Dis, 2022, 40(2): 146-152. (in Chinese)
	(罗卓韦, 周正斌, 公衍峰, 等. 我国内脏利什曼病的流行现状和防控挑战[J]. 中国寄生虫学与寄生虫病杂志, 2022, 40(2): 146-152.)
[8]	Hygienic and Antiepidemic Station of Shijiazhuang District. Collection of epidemic data from 1974 to 1983 in Shijiazhuang, Hebei Province[C]. 1984: 6. (in Chinese)
	( 石家庄地区卫生防疫站.1974—1983年河北省石家庄地区疫情资料汇编[C]. 1984: 6.)
[9]	Chen J, Wei ZY, Li H, et al. Epidemiological characteristics and spatio-temporal cluster analysis of kala-azar in Shanxi Province[J]. Chin Remedies Clin, 2021, 21(11): 1955-1956. (in Chinese)
	(陈靖, 魏志云, 李虹, 等. 山西省黑热病流行病学特征及时空聚类分析[J]. 中国药物与临床, 2021, 21(11): 1955-1956.)
[10]	Zhou ZB, Li YY, Zhang Y, et al. Prevalence of visceral leishmaniasis in China in 2018[J]. Chin J Parasitol Parasit Dis, 2020, 38(2): 175-180, 187. (in Chinese)
	(周正斌, 李元元, 张仪, 等. 2018年全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(2): 175-180, 187.)
[11]	Wang FP, Chen S, Liu DL, et al. Characteristics and risk factors of the kala-azar in Hancheng City, Shaanxi Province, China[J]. Chin J Zoonoses, 2018, 34(8): 756-760. (in Chinese)
	(王凤萍, 陈飒, 刘东立, 等. 陕西省韩城市黑热病流行特征及高危因素分析[J]. 中国人兽共患病学报, 2018, 34(8): 756-760.)
[12]	Zhao YZ, Tie P, Bai YF, et al. Epidemiological characteristics of visceral leishmaniasis--Shanxi Province, China, 1950—2019[J]. China CDC Wkly, 2022, 4(28): 614-617.
[13]	Duan XH. Retrospective investigation and analysis of 82 cases of kala-azar in Yangquan City, Shanxi Province[J]. Shanxi Med J, 2021, 50(13): 2019-2020. (in Chinese)
	(段秀红. 山西省阳泉市82例黑热病病例回顾性调查分析[J]. 山西医药杂志, 2021, 50(13): 2019-2020.)
[14]	Zhang PJ, Zhou ZB, Li YY, et al. Prevalence of mountain-zoonotic type visceral leishmaniasis in Yangquan City of Shanxi Province from 2015 to 2020[J]. Chin J Schisto Control, 2022, 34(5): 493-499. (in Chinese)
	(张佩君, 周正斌, 李元元, 等. 2015—2020年山西省阳泉市犬源型内脏利什曼病疫情调查[J]. 中国血吸虫病防治杂志, 2022, 34(5): 493-499.)

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