Epidemiological and spatio-temporal distribution characteristics of visceral leishmaniasis in Kashi Prefecture, Xinjiang, 2005-2022

doi:10.12140/j.issn.1000-7423.2024.03.008

Abstract

Abstract:

Objective To analyze the epidemiological characteristics and spatio-temporal distribution of visceral leishmaniasis (VL) in Kashi Prefecture, Xinjiang, from 2005 to 2022, to provide a scientific basis for formulating prevention and control strategies for VL in Kashi area. Methods Data on VL cases reported in Kashi Prefecture, Xinjiang, from 2005 to 2022 were collected from the National Diseases Reporting Information System. Descriptive epidemiological methods were used to analyze the three-dimensional distribution characteristics of VL. Spatial auto-correlation analysis was performed using Geoda 1.22 software, and spatio-temporal scanning statistical analysis was performed using SaTScan 10.1.2 software. Results From 2005 to 2022, a total of 1 965 VL cases were reported in Kashi Prefecture, Xinjiang, with an average annual incidence rate of 0.13 per 100 000 people. The peak incidence years were 2008 and 2015, with incidence rates of 6.10 per 100 000 (363 cases) and 8.29 per 100 000 (396 cases), respectively. Among the population distribution characteristics, 1 125 cases were male and 840 were female, with a male-to-female ratio of 1.34 ∶ 1. Cases were reported across all age groups, with the composition rate of 75.47% (1 483/1 965) in the 0-4 years age group. The high-risk population was scattered children (75.32%, 1 480/1 965). VL cases were reported monthly from 2005 to 2022, with noticeable seasonal distribution between 2008-2010 and 2014-2016, peaking from September to December. VL mainly occurred in the northern counties of Kashi, with the highest incidence rate in Jiashi County (15.84/100 000), Kashi City (4.10/100 000), Shufu County (1.30/100 000), and Bachu County (1.21/100 000). The results of spatial auto-correlation analysis revealed a significant positive spatial correlation in the incidence of VL in Kashi Prefecture, Xinjiang in 2012 (Moran’s I = 0.126 5, Z = 2.193 2, P < 0.05). Local autocorrelation analysis exhibited that high-high clustering areas were mainly distributed in Shufu County, Kashgar City, Jiashi County and Shule County. Spatiotemporal scanning analysis showed that the main clustering area was Jiashi County, and a high incidence period was from 2008 to 2016. Conclusion From 2005 to 2022, the overall incidence of VL exhibited a downward trend in Kashi Prefecture, Xinjiang. The high-risk population consisted mainly of young scattered children, and the northern counties of Kashi were the high endemic areas of VL.

Key words: Visceral leishmaniasis, Epidemiologic characteristics, Spatial autocorrelation, Spatio-temporal scanning analysis, Kashi Prefecture, Xinjiang

CLC Number:

R531.6

MAIMAITIJIANG Umar, YALIKUN Maimaitiyiming, SHI Guangzhong, AYIXIAMU Keyoumu, ZHAO Jiangshan. Epidemiological and spatio-temporal distribution characteristics of visceral leishmaniasis in Kashi Prefecture, Xinjiang, 2005-2022[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2024, 42(3): 332-339.

Figures/Tables 8

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Table 1

Table 2

Table 3

Table 4

References 22

[1]	Burza S, Croft SL, Boelaert M. Leishmaniasis[J]. Lancet, 2018, 392(10151): 951-970.
[2]	Alvar J, Yactayo S, Bern C. Leishmaniasis and poverty[J]. Trends Parasitol, 2006, 22(12): 552-557.
[3]	Wang JY, Cui G, Chen HT, et al. Current epidemiological profile and features of visceral leishmaniasis in People’s Republic of China[J]. Parasit Vectors, 2012, 5: 31.
[4]	Zhou ZB, Pan GQ, Li YY, et al. Prevalence of visceral leishmaniasis in China in 2021[J]. Chin J Parasitol Parasit Dis, 2023, 41(2): 149-155. (in Chinese)
	(周正斌, 潘改芹, 李元元, 等. 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.)
[5]	Li Y, Zheng CJ. Associations between meteorological factors and visceral leishmaniasis outbreaks in Jiashi County, Xinjiang Uygur Autonomous Region, China, 2005-2015[J]. Int J Environ Res Public Health, 2019, 16(10): 1775.
[6]	Luo Y, Abulimiti SNWR. Epidemiological characteristics of kala-azar in Kashgar from 2011 to 2020[J]. Bull Dis Contr Prev China, 2022, 37(1): 46-49. (in Chinese)
	(罗英, 斯那瓦尔?阿布力米提. 2011—2020年喀什市黑热病流行特征分析[J]. 疾病预防控制通报, 2022, 37(1): 46-49.)
[7]	Kulldorff M, Athas WF, Feurer EJ, et al. Evaluating cluster alarms: a space-time scan statistic and brain cancer in Los Alamos, New Mexico[J]. Am J Public Health, 1998, 88(9): 1377-1380.
[8]	Zheng CJ, Wang LP, Li Y, et al. Visceral leishmaniasis in Northwest China from 2004 to 2018: a spatio-temporal analysis[J]. Infect Dis Poverty, 2020, 9: 165.
[9]	Yang HJ, Sun JL, Zheng CJ, et al. Epidemiological characteristics of visceral leishmaniasis in China, 2017-2021[J]. Dis Surveillance, 2023, 38(6): 676-681. (in Chinese)
	(杨慧军, 孙军玲, 郑灿军, 等. 2017—2021年全国内脏利什曼病流行特征分析[J]. 疾病监测, 2023, 38(6): 676-681.)
[10]	Yan CY, Ai SJ, Kai S. Epidemiological analysis on kala-azar cases during 1990-2014 in Kashi Prefecture, Xinjiang, China[J]. Int J Med Parasit Dis, 2015, 42(5): 276-279. (in Chinese)
	(严超英, 艾山江, 凯赛. 新疆喀什地区1990—2014年内脏利什曼病疫情分析[J]. 国际医学寄生虫病杂志, 2015, 42(5): 276-279.)
[11]	Liu LL, Guan ZP, Li F, et al. Retrospective analysis of epidemic feature of visceral leishmaniasis in Wen County of Gansu Province from 2009 to 2017[J]. Bull Dis Contr Prev China, 2019, 34(1): 29-31, 57. (in Chinese)
	(刘林林, 关真平, 李凡, 等. 2009—2017年甘肃省文县内脏利什曼病流行特征回顾分析[J]. 疾病预防控制通报, 2019, 34(1): 29-31, 57.)
[12]	Ma L, Cao L, Qiu L, et al. Prevalence characteristics and space-time clustering of leishmaniasis in Shaanxi Province[J]. Chin J Public Health, 2018, 34(7): 1021-1025. (in Chinese)
	(马琳, 曹磊, 邱琳, 等. 陕西省黑热病流行病学特征及时空聚类分析[J]. 中国公共卫生, 2018, 34(7): 1021-1025.)
[13]	Dai PF, Tian XD, Zhao JY, et al. Epidemiological characteristics of visceral leishmaniasis in Shanxi Province, China, 2020[J]. Chin J Vector Biol Control, 2022, 33(3): 405-408. (in Chinese)
	(代培芳, 田晓东, 赵俊英, 等. 山西省2020年黑热病流行特征分析[J]. 中国媒介生物学及控制杂志, 2022, 33(3): 405-408.)
[14]	Osman YSLY, Simayi ADL, Keyumu KSE, et al. Investigation on the outbreak of visceral leishmaniasis in 2014 in Jiashi County of Xinjiang[J]. Chin J Parasitol Parasit Dis, 2015, 33(5): 357-361. (in Chinese)
	(伊斯拉音?乌斯曼, 阿迪力?司马义, 凯赛尔?克尤木, 等. 2014年新疆伽师县内脏利什曼病暴发的调查分析[J]. 中国寄生虫学与寄生虫病杂志, 2015, 33(5): 357-361.)
[15]	Li RZ, Huo F, Li L, et al. Epidemic characteristics and transmission risk of leishmaniasis in Jiuzhaigou County in Sichuan Province from 2010 to 2021[J]. Occup Health Damage, 2023, 38(4): 231-235. (in Chinese)
	(李荣智, 霍芳, 李黎, 等. 2010—2021年九寨沟县黑热病流行特征及传播风险[J]. 职业卫生与病伤, 2023, 38(4): 231-235.)
[16]	Zhou ZB, Li YY, Zhang Y, et al. Prevalence of visceral leishmaniasis in China in 2019[J]. Chin J Parasitol Parasit Dis, 2020, 38(5): 602-607. (in Chinese)
	(周正斌, 李元元, 张仪, 等. 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): 602-607.)
[17]	Snider H, Lezama-Davila C, Alexander J, et al. Sex hormones and modulation of immunity against leishmaniasis[J]. Neuroimmunomodulation, 2009, 16(2): 106-113.
[18]	Meng BL, Osman YSLY, Gao CD, et al. Investigation on the prevalence of kala-azar in Kashgar, Xinjiang from 2004 to 2006[J]. Endem Dis Bull, 2009, 24(1): 69-70. (in Chinese)
	(孟波林, 伊斯拉音?乌斯曼, 高春代, 等. 2004—2006年新疆喀什地区黑热病流行现况调查[J]. 地方病通报, 2009, 24(1): 69-70.)
[19]	Zhou ZB, Li YY, Zhang Y, et al. Prevalence of visceral leishmaniasis in China during 2015-2018[J]. Chin J Parasitol Parasit Dis, 2020, 38(3): 339-345. (in Chinese)
	(周正斌, 李元元, 张仪, 等. 2015—2018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(3): 339-345.)
[20]	Guan LR, Shen WX. Recent advances in visceral leishmaniasis in China[J]. Southeast Asian J Trop Med Public Health, 1991, 22(3): 291-298.
[21]	Talmoudi K, Bellali H, Ben-Alaya N, et al. Modeling zoonotic cutaneous leishmaniasis incidence in central Tunisia from 2009-2015: forecasting models using climate variables as predictors[J]. PLoS Negl Trop Dis, 2017, 11(8): e0005844.
[22]	Zheng CJ, Xue CZ, Wu WP, et al. Epidemiological characteristics of kala-azar disease in China, during 2005-2015[J]. Chin J Epidemiol, 2017, 3(4): 431-434. (in Chinese)
	(郑灿军, 薛垂召, 伍卫平, 等. 我国2005—2015年黑热病报告病例流行特征分析[J]. 中华流行病学杂志, 2017, 3(4): 431-434.)

年份Year	发病率/10万 Incidence rate/100 000
年份Year	巴楚县 Bachu County	伽师县 Jiashi County	喀什市Kashi City	麦盖提县Maigaiti County	莎车县Shache County	疏附县Shufu County	疏勒县Shule County	塔什库尔干塔吉克自治县 Tajik Autonomous County of Taxkorgan	叶城县 Yecheng County	英吉沙县Yingjisha County	岳普湖县Yuepuhu County	泽普县Zepu County
2005	0.74	2.98	16.1	0	0.75	3.75	2.28	0	0	0.43	0	0
2006	0.97	0	8.36	0.45	1.02	5.29	0	0	0	1.29	0	0
2007	0.71	5.47	7.41	0	0.14	3.62	0.31	0	0	1.68	0	0
2008	2.31	56.75	6.73	0.43	0.28	2.52	1.23	0	0	0.41	2.05	0.48
2009	1.59	50.95	9.67	0.84	0.14	2.97	0.60	0	0	1.20	2.68	0
2010	1.78	10.02	10.31	0.42	0.14	2.67	1.49	0	0	0	1.98	0
2011	0.45	1.10	6.14	0.85	0.14	0.74	0.91	0	0	0.40	0.67	0
2012	0	0.52	2.78	0	0.26	0.32	0.64	0	0	0.38	0.67	0
2013	0	0.51	1.58	0	0	0.64	0	0	0	0	0	0.48
2014	1.77	33.54	1.18	0	0	0	0	0	0	0.74	0.66	0
2015	5.24	89.09	0.97	0	0.13	0	0.31	0	0.21	1.09	1.96	0.47
2016	4.53	31.65	1.13	0.36	0.74	0	0.30	0	0.21	0	4.44	1.38
2017	0.84	1.45	0.37	0	1.23	0.91	0.60	0	0	0.35	0	0.91
2018	0.28	0.24	0.73	0	0	0	0.30	0	0	1.03	0.62	0
2019	0	0.24	0	0	0	0	0	0	0	0	0	0
2020	0	0.23	0.28	0	0	0	0	0	0	0	0	0
2021	0.28	0.24	0	0	0	0	0.30	0	0	0	0	0
2022	0.27	0.24	0	0	0	0	0	0	0	0	0	0

年份 Year	莫兰指数 Moran’s I	标准差 Standard deviation	Z值 Z value	P值 P value
2005	0.083 1	0.089 3	1.974 7	0.054
2006	0.142 5	0.145 7	1.617 8	0.043
2007	0.240 1	0.171 4	1.770 4	0.066
2008	-0.063 4	0.050 8	0.598 8	0.235
2009	-0.039 0	0.064 1	0.865 1	0.127
2010	0.123 8	0.161 5	1.371 8	0.058
2011	0.033 8	0.074 7	1.693 1	0.065
2012	0.126 5	0.100 3	2.193 2	0.042
2013	0.032 8	0.140 0	0.890 9	0.151
2014	-0.082 3	0.042 6	0.244 0	0.305
2015	-0.090 3	0.042 5	0.051 9	0.348
2016	-0.085 8	0.065 7	0.083 8	0.411
2017	-0.186 6	0.187 1	-0.513 7	0.330
2018	0.082 3	0.165 9	1.114 0	0.107
2019	-0.088 3	0.037 7	0.116 2	0.310
2020	0.028 3	0.148 6	0.836 3	0.090
2021	-0.141 5	0.164 6	-0.265 7	0.470
2022	-0.110 7	0.151 3	-0.134 3	0.486

年份Year	高-高聚集区域 High-high cluster area	高-低聚集区域 High-low cluster area	低-低聚集区域 Low-low cluster area	低-高聚集区域 Low-high cluster area
2005	疏附县 Shufu County	喀什市 Kashi City	泽普县 Zepu County	英吉沙县 Yingjisha County
2006	-	-	-	-
2007	疏附县，喀什市 Shufu County, Kashi City	-	泽普县 Zepu County	疏勒县 Shule County
2008	喀什市 Kashi City	-	泽普县，叶城县 Zepu County, Yecheng County	英吉沙县 Yingjisha County
2009	喀什市 Kashi City	-	叶城县 Yecheng County	疏勒县 Shule County
2010	喀什市 Kashi City	-	泽普县，叶城县 Zepu County, Yecheng County	-
2011	伽师县 Jiashi County	喀什市 Kashi City	叶城县 Yecheng County	疏附县 Shufu County
2012	伽师县，喀什市，疏勒县 Jiashi County, Kashi City, Shule County	-	-	疏附县，英吉沙县 Shufu County, Yingjisha County
2013	-	泽普县 Zepu County	-	疏勒县，英吉沙县 Shule County, Yingjisha County
2014	-	-	-	-
2015	-	-	-	麦盖提县 Maigaiti County
2016	-	-	-	麦盖提县 Maigaiti County
2017	-	巴楚县 Bachu County	-	英吉沙县 Yingjisha County
2018	喀什市 Kashi City	巴楚县 Bachu County	-	疏附县，伽师县 Shufu County, Jiashi County
2019	-	伽师县 Jiashi County	-	-
2020	-	-	-	疏附县，英吉沙县，岳普湖县 Shufu County, Yingjisha County, Yuepuhu County
2021	-	巴楚县 Bachu County	-	-
2022	-	巴楚县，伽师县 Bachu County, Jiashi County	-	麦盖提县 Maigaiti County

聚集区类型 Clusters type	聚集时间Cluster time	地区 Region	半径/km Radiue/km	对数似然比Log likelihood ratio	实际报告病例数/例 No. actual reported cases	期望病例数/例 No. expected cases	相对危险度 Relative risk	P值 P value
主要聚集区 Main cluster	2008—2016	伽师县 Jiashi County	0	2 135.75	1 050	78.25	33.83	< 0.01
次级聚集区 Secondary cluster	2005—2011	喀什市 Kashi City	0	169.08	247	61.45	4.54	< 0.05
	2014—2022	叶城县 Yecheng County	0	92.64	2	99.52	0.02	< 0.05
	2014—2022	疏勒县/英吉沙县 Shule County/Yingjisha County	53.53	83.88	15	127.00	0.11	< 0.05
	2014—2022	疏附县 Shufu County	0	56.69	3	67.77	0.04	< 0.05
	2014—2022	麦盖提县 Maigaiti County	0	52.75	1	56.84	0.02	< 0.05
	2006—2014	泽普县 Zepu County	0	35.15	2	42.77	0.05	< 0.05
	2017—2022	巴楚县 Bachu County	0	31.41	6	49.50	0.12	< 0.05