2020-2022年山西省阳泉市内脏利什曼病监测与干预分析

Epidemiological characteristics and intervention analysis of visceral leishmaniasis in Yangquan, Shanxi, 2020−2022

  • 摘要:
    目的 分析山西省阳泉市内脏利什曼病的分布特点,探讨防控措施效果。
    方法 选择阳泉市2020—2022年内脏利什曼病的报告数据及流行病学调查资料,同时收集阳泉市2020—2022年犬只检测处置、媒介监测、健康教育等防控和干预措施数据,采用SPSS 26.0软件和R4.4.1软件统计分析阳泉市内脏利什曼病分布特点及防控干预措施效果。
    结果 2020—2022年期间阳泉市报告内脏利什曼病例236例,报告病例数分别为82、97和57例,年发病率依次为5.78/10万、7.36/10万和4.34/10万,发病率差异具有统计学意义;内脏利什曼病在各年龄组均有分布,60~岁年龄组报告病例数最多,占所有报告病例数的26.27%,男性163例,女性73例,男女性别比为2.23∶1;农民为内脏利什曼病的高危职业;病例分布于5个县(区),其中平定县报告病例数最多(94例),其次是郊区(68例),盂县报告病例数最少(14例);报告病例存在季节差异(Z=−2.19,P=0.03);2020—2022年期间分别管控流浪犬632425881539只,管控的流浪犬数量逐年下降;2020—2022年累计检测家养犬78396只,血清抗体阳性犬4981只,阳性率为6.35%,家养犬只检测阳性率由7.58%降至3.71%;捕获中华白蛉8033只,平均密度为 3.78只/(灯·夜),与2020年相比,2021年的白蛉高峰密度下降了38.04%。
    结论 阳泉市内脏利什曼病2020-2022年发病率总体呈下降趋势,通过综合干预措施,防控效果明显,但仍需要进一步探索“人–动物–媒介”多维度的监测和干预体系,进一步研究各项干预措施的干预效果,用低成本措施和全健康理念推进黑热病防治工作。

     

    Abstract:
    Objective To analyze the distribution characteristics of visceral leishmaniasis in Yangquan city, Shanxi province, and explore the effectiveness of prevention and control measures.
    Methods The report data and epidemiological investigation data of visceral leishmaniasis in Yangquan city from 2020 to 2022 were selected, and the data of prevention control and intervention measures such as detection and disposal of dogs, vector surveillance and health education were collected. The distribution characteristics of visceral leishmaniasis and the effect of prevention and control intervention measures were analyzed statistically in Yangquan city by software SPSS 26.0 and R4.4.1.
    Results During 2020−2022, 236 cases of visceral leishmania were reported in Yangquan city, and the number of repored cases were 82, 97 and 57, respectively. The annual incidence rates were 5.78/100 000, 7.36/100 000 and 4.34/100 000, respectively, and the incidence difference was statistically significant. Visceral leishmaniasis was distributed in all age groups, and the age group of 60− 69 years old reported the most cases, accounting for 26.27% of all reported cases. There were 163 males and 73 females with a sex ratio of 2.23∶1. Farmers are high-risk occupations for visceral leishmaniasis; The cases were distributed in 5 counties (districts), among which Pingding county reported the most cases (94 cases), followed by suburban area (68 cases), and Yuxian reported the least cases (14 cases). There was a difference in seasons of reported cases. From 2020 to 2022, 6 324, 2 588 and 1 539 stray dogs were controlled, respectively, and the number of stray dogs under control decreased year by year. From 2020 to 2022, a total of 78396 domestic dogs were detected, including 4981 serum-antibody positive dogs, with a positive rate of 6.35%, and the positive rate of domestic dogs decreased from 7.58% to 3.71%. A total of 8033 Chinese Phlebotomus were captured, with an average density of 3.78 phlebotomus/(light · night), and the peak density of phlebotomus in 2021 decreased by 38.04% compared with 2020.
    Conclusion In recent 3 years, the incidence of visceral leishmaniasis in Yangquan city showed a decreasing trend, and the effectiveness of prevention and control was obvious through comprehensive intervention measures. However, it is still necessary to further explore the multi-dimensional monitoring and intervention system of “human-animal-vector”, further study the intervention effect of various intervention measures, and promote the prevention and control of kala-azar with low-cost measures and whole-health concept.

     

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