2019-2023年山西省内脏利什曼病监测结果分析

Surveillance for visceral leishmaniasis in Shanxi, 2019-2023

  • 摘要:
    目的 了解山西省人群内脏利什曼病流行特征和变化趋势,分析监测县宿主利什曼原虫感染情况及媒介密度变化情况,为制定内脏利什曼病防治策略提供依据。
    方法 收集中国疾病预防控制中心传染病报告信息管理系统中2019—2023年现住址为山西省的内脏利什曼病病例信息,采用描述性流行病学方法对收集病例流行特征、流行县变化情况进行分析。 从报告病例数最多的阳泉、临汾、长治3个地级市中选定一个县作为固定监测县,开展犬只利什曼原虫感染情况和白蛉密度消长监测。
    结果 2019—2023年山西省累计报告内脏利什曼病506例,死亡1例,年均报告发病率为1.42/10万。 报告病例数最多的3个市为阳泉市、临汾市和长治市,分别为328例、91例、41例,合计占全省报告病例总数的90.90%;5年共新增流行县17个。 报告病例男女性别比为2.49∶1, 职业以散居农民和散居儿童最多,年龄分布以0~<3岁组婴幼儿最多。 5年共采集犬只血清1 595份,检测阳性139份,阳性率为8.71%。2020—2023年山西省检测县白蛉总平均密度为23.84(只/灯·夜)。 每年5月下旬开始出现白蛉,6月下旬平均密度最高为72.36(只/灯·夜),9月下旬基本消失。
    结论 山西省内脏利什曼病病例数快速上升的趋势得到控制,但流行范围仍在不断扩大。 犬只利什曼原虫感染率呈现下降趋势,但白蛉密度仍然较高,应加强犬只管理及媒介生物控制工作。

     

    Abstract:
    Objective To understand the epidemiological characteristics and incidence trends of visceral leishmaniasis in the population in Shanxi province, the host infection status of Leishmania and vector density in the monitored county in the province, and provide evidence for the development of visceral leishmaniasis prevention and control strategies.
    Methods   The information on visceral leishmaniasis case in Shanxi from 2019 to 2023 were colleceted from the Infectious Disease Reporting and Information Management System of Chinese Center for Disease Control and Prevention for a descriptive epidemiological analysis. The case epidemiological investigation information were collected to analyze the changes of affected counties.One county was selected from each of the three most severely affected prefectures(Yangquan, Linfen,and Changzhi) to conduct surveillance for the infection status of Leishmaniasis in dogs and the changes of sandfly density.
    Results From 2019 to 2023, a total of 506 cases of visceral leishmaniasis, including 1 death, were reported in Shanxi, an annual incidence rate was 1.42/ 100 000. The reported cases count was the highest in Yangquan(328), followed by Linfen(91) and Changzhi(41). The cases reported in these areas accounted for 90.90% of the total reported cases in the province. There were 17 new endemic counties during 5 years. The male-to-female ratio of the reported cases was 2.49∶1.The cases were mainly farmers and home-cared children. The cases reported in age group 0~<3 years accounted for the largest proportion. A total of 1 595 canine serum samples were collected over 5 years, in which 139 were positive, with a positive rate of 8.71%. The average sandfly density was 23.84 per lamp-night in the monitored counties from 2020 to 2023. During the surveillance period, sandflies began to appear at the end of May, with the average density of sandflies researching its peak in the end of June, at 72.36 per lamp-night, and then disappeared at the end of September.
    Conclusion The rapidly increase of visceral leishmaniasis incidence in Shanxi had been basically contained, but the epidemic range continues to expand. The infection rate in dogs showed a downward trend, but the sandfly density remained to be high, so the management of dogs and vector control should be further strengthened .

     

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