目的 了解2018年全国内脏利什曼病的疫情状况。方法 收集2018年中国疾病预防控制中心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病例的三间分布进行描述性流行病学分析。结果 2018年全国11个省份的78个县共报告内脏利什曼病180例,病例主要分布于甘肃（66例）、山西（38例）和陕西（27例）等3个省。其中40个县属于流行区,共报告本地感染病例134例,其余38个县属于非流行区,共报告输入性病例46例。其中甘肃省舟曲县（22例）、宕昌县（18例）和武都区（10例）为主要流行县,报告病例占全国总报告病例数的27.8%（50/180）。陕西省渭南市化州区和临渭区再现本地感染病例,为内脏利什曼病复燃流行县。内脏利什曼病发病高峰为4-6月,男女病例比为1 ∶ 0.7。农民和儿童是我国内脏利什曼病高风险人群,分别占全部病例数的42.2%（76/180）和34.5%（55/180）。内脏利什曼病病例主要分布于≥ 15岁年龄组,不同流行类型病例年龄分布明显不同,野生动物源型病例主要分布于0~2岁婴幼儿,人源型与犬源型病例主要分布于≥ 15岁农民。结论 我国内脏利什曼病呈低度流行态势,但流行区范围逐渐蔓延。

Objective To understand the prevalence of visceral leishmaniasis in China in 2018.Methods Information of visceral leishmaniasis cases in 2018 was collected from the web-based National Diseases Reporting Information System (NDRIS) operated by the Chinese Center for Disease Control and Prevention. A database was established, excluding suspected cases, duplicates and cutaneous leishmaniasis cases. The three-dimensional distribution of visceral leishmaniasis cases was descriptively analyzed using Microsoft Excel 2016.Results In 2018 a total of 180 cases of visceral leishmaniasis were reported in 78 counties of 11 provinces (autonomous regions and municipalities), mainly distributed in Gansu (66 cases), Shanxi (38) and Shaanxi Provinces (27). Forty counties were endemic regions of visceral leishmaniasis, with a total of 134 reported indigenous cases, and the other 38 counties were non-endemic regions, with a report of 46 imported cases of visceral leishmaniasis. Particularly, Zhouqu county, Dangchang county and Wudu district were the major prevalent counties with 22, 18 and 10 cases reported, respectively, accounting for 27.8% (50/180) of the total cases reported. The Huazhou district and Linwei district of Weinan City in Shaanxi Province reported re-emergence of indigenous visceral leishmaniasis cases, being recognized as the visceral leishmaniasis-reemerging regions. The occurrence of visceral leishmaniasis peaked from April to June, with a male/female ratio of 1 ∶ 0.7. Farmers and children were at a high risk of visceral leishmaniasis, accounting for 42.2% (76/180) and 34.5% (55/180) of the total, respectively. The visceral leishmaniasis cases were mainly distributed in the people at ages of ≥15 years. The age distribution varied significantly among different types of the disease, with the desert-type zoonotic visceral leishmaniasis distributed mainly in infants of age 0-2 years, and the anthroponotic and mountain-type zoonotic visceral leishmaniasis distributed mainly in farmers aged ≥15 years.Conclusion The visceral leishmaniasis is endemic at low prevalence in China, but the endemic area is extending gradually.