目的 分析2004-2016年中国内脏利什曼病分布状况及流行病学特点,为制定防治策略提供依据。 方法 用Microsoft Excel 2016软件对2004-2016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疫情报告数据进行统计和分析,其中非流行区报告病例由中国疾病预防控制中心寄生虫病预防控制所联系各省（直辖市、自治区）疾病预防控制中心进行调查核实。 结果 2004-2016年全国24个省（直辖市、自治区）共报告内脏利什曼病病例4 448例,各年份分别为306、311、270、355、518、523、375、300、219、158、293、510和310例;全年均有病例报告,伽师县内脏利什曼病报告病例数的峰值在10-11月,伽师县以外区域报告病例数的峰值在3-5月。流行区为7个省（自治区）24个地市（州、盟）83个流行县（区、市）,7个省（自治区）分别为新疆、甘肃、四川、陕西、山西、内蒙古和河南。流行县最多的是新疆,为46个县。2004-2016年7个流行区省（直辖市、自治区）报告病例4 364例,占全国报告病例的98.1%,其中新疆（包括新疆生产建设兵团）、甘肃和四川报告病例4 251例,占全国报告病例的95.6%;17个非流行区省（直辖市、自治区）报告病例84例,占全国报告病例的1.9%。内脏利什曼病流行区从20世纪90年代的43个流行县,增加到目前的83个。最新复燃的流行区为河南省的林州市,乌什县和莎车县为历史复燃的流行县。2016年内脏利什曼病非流行区共报告内脏利什曼病12例,经核实均为输入性病例。4 448病例中,男性2 712例,女性1 736例,男女性别比为1.6:1;平均年龄12.3岁,主要集中在5岁以下,占全部病例的54.9%;散居儿童和农民共3 228例,占全国报告病例的72.6%。 结论 我国内脏利什曼病在中西部地区呈散发状态,病例极为分散,局部有疫情暴发和复燃,除暴发区域之外报告病例呈下降趋势,但流行区范围正在逐渐扩大。

Objective To analyze the endemic status and epidemiological characteristics of visceral leishmaniasis in China from 2004 to 2016, so as to provide basis for the formulation of prevention and control strategies. Methods The data for the visceral leishmaniasis endemic in China from 2004 to 2016 were collected from Infectious Disease Reporting Management System of China Center for Disease Control and Prevention(CDC) and analyzed by Microsoft Excel 2016. For those cases reported in non-endemic areas, the infection information will be confirmed and verified by the local provincial CDC. Results A total of 4 448 cases of visceral leishmaniasis were reported in 24 provinces (municipalities or autonomous regions) in China from 2004 to 2016, with specific case number of 306, 311, 270, 355, 518, 523, 375, 300, 219, 158, 293, 510 and 310 cases for each year, respectively. The visceral leishmaniasis cases were reported throughout the year, but the peak was among October to November in Jiashi endemic county and among March to May for the rest of endemic areas. Total 98.1% (4 364/4 448) of the reported cases came from endemic areas, mainly from Xinjiang （including Xinjiang Production and Construction Corps）, Gansu and Sichuan provinces which account for 95.6% of the reported cases nationwide. Only 84 cases of visceral leishmaniasis were reported in 17 non-endemic regions, accounting for 1.9% of the reported cases. The visceral leishmaniasis endemic areas were located in 83 counties in 7 provinces or autonomous regions, among them 46 endemic counties located in Xinjiang Autonomous Region. The case reported counties are increased from 43 in 1990 to 83 in 2016, with reemerging areas in Linzhou, Wushi and Shache counties in Henan province. Total 12 visceral leishmaniasis cases were reported in non-endemic areas in 2016, all were confirmed to be imported cases. Among the total reported cases, 2 712 were male and 1 736 were female with a ratio of male to female to 1.6:1. The average age of reported cases was 12.3, mainly under 5 years old which accounts for 54.9% of total cases. Children and farmers were the most vulnerable population for visceral leishmaniasis which account for 72.6% of reported cases(3 228/4 448). Conclusion Visceral leishmaniasis endemic is sporadic in the middle western areas of China, with sporadic outbreaks and reemergence in some areas. The reported cases are decreasing except for those outbreak areas, but the endemic areas is growing.