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目的了解2014年新疆维吾尔自治区(简称新疆)伽师县内脏利什曼病暴发的流行病学特点,为制定相关防治策略提供依据。方法从中国疾病预防控制中心传染病报告信息管理系统(简称报告系统)中收集新疆上报的2009年7月1日-2015年6月30日内脏利什曼病疫情数据,进行整理分析。于2014年10月对当年7月1日以来报告内脏利什曼病例数剧增的伽师县卧里托格拉克乡、和夏阿瓦提乡的23个村(3岁以下儿童)开展现场流行病学调查,对有发热,肝、脾肿大等症状和体征者(为疑似病例)采集手指血20μl(监护人知情同意)进行rk39免疫层析试条检测,并对阳性患儿给予葡萄糖酸锑纳(200 mg/kg×6次,静脉给药)治疗。结果 2009年7月1日-2015年6月30日新疆共报告内脏利什曼病813例,其中伽师县占41.45%(337/813);2014年7月1日-2015年6月30日共报告病例数为192例,其中伽师县占86.46%(166/192)。2014年在伽师县,自8月出现首个内脏利什曼病例后,报告病例数呈上升的趋势,10、11和12月报告病例数为114例,占当期报告病例数的68.7%(114/166),至2015年4月无病例报告。2014年7月1日-2015年6月30日,伽师县报告的166例内脏利什曼病病例中,年龄为出生23 d~8岁,其中1岁以下占95.18%(158/166);伽师县卧里托格拉克乡报告的113例中,年龄为出生23 d~3岁,其中1岁以下占96.46%(109/113),符合荒漠型内脏利什曼病流行的特点。现场调查和夏阿瓦提乡和卧里托格拉克乡23个村3岁以下儿童833人,其中14例疑似病例经rk39免疫层析试条检测,阳性者11例,均经葡萄糖酸锑纳治疗1个疗程后治愈出院。结论 2014年伽师县内脏利什曼病报告疫情中95%为1岁以下儿童,确定为荒漠型内脏利什曼病暴发。
Objective To understand the epidemiological characteristics of visceral leishmaniasis outbreaks in Jiashi County, Xinjiang Uygur Autonomous Region (hereinafter referred to as Xinjiang) in 2014, and to provide evidence for the establishment of related prevention and control strategies. Methods The data of visceral leishmaniasis in Xinjiang from July 1, 2009 to June 30, 2015 were collected from the Infectious Diseases Reporting Information Management System (abbreviated as report system) of China CDC and analyzed. In October 2014, the number of cases of visceral leishmania in Toguri Togliudh Township of Jiashi Prefecture reported since July 1 of that year and 23 villages (children under 3 years old) in Shah Awat Township were on the scene Epidemiological survey, fever, liver, splenomegaly and other symptoms and signs (suspected cases) finger blood 20μl (guardian informed consent) rk39 immunochromatographic test strips, and positive children given gluconic acid Antimony sodium (200 mg / kg × 6 times, intravenous) treatment. Results A total of 813 visceral leishmaniasis cases were reported in Xinjiang from July 1, 2009 to June 30, 2015, with Jiashi County accounting for 41.45% (337/813); July 1, 2014 to June 30, 2015 Japan reported a total of 192 cases of cases, of which Jiashi County accounted for 86.46% (166/192). In Jiashi County in 2014, the number of cases reported after the first visceral leishmaniasis in August showed an upward trend, with 114 reported cases in October, November and December, accounting for 68.7% of the reported cases in the current reporting period 114/166) and no case report until April 2015. From July 1, 2014 to June 30, 2015, of the 166 cases of visceral leishmaniasis reported in Jiashi County, the age ranged from 23 days to 8 years, of which 95.18% (158/166) were under 1 year old ; Among the 113 reported cases of Togolejalak Township, Jiashi County, the age ranged from 23 d to 3 years old, of which 96.46% (109/113) under 1 year old, in line with the prevalence of desert type visceral leishmaniasis. On-the-spot investigation and 833 children under 3 years of age in 23 villages of Shahwati and Hoi Torajlak Township, of which 14 suspected cases were tested by rk39 immunochromatographic test strips and 11 were positive, all of which were treated with antimony natrium gluconate A course of treatment cured after discharge. Conclusion 95% of the cases of visceral leishmaniasis reported in 2014 in Jiashi County were children under the age of 1, and were identified as desert type visceral leishmaniasis outbreaks.