2020—2023年四川省疾病预防控制中心接诊内脏利什曼原虫病病例分析  

Cases analysis of visceral leishmaniasis diagnosed at preventive medicine clinic of Sichuan CDC from 2020 to 2023

作　　者：凌攀[1] 赵仪[1] 王晓凤[1] 杨柳莹[1] 陈曦阳[1] 赵芹弘 葛芾显 曾珍 LING Pan;ZHAO Yi;WANG Xiaofeng;YANG Liuying;CHEN Xiyang;ZHAO Qinhong;GE Fuxian;ZENG Zhen(Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川省疾病预防控制中心,成都610041

出　　处：《寄生虫病与感染性疾病》2024年第3期144-148,共5页Parasitoses and Infectious Diseases

摘　　要：目的 分析四川省内脏利什曼原虫病病例的流行病学特征,为优化该地区内脏利什曼原虫病的控制措施提供依据。方法 采用内脏利什曼原虫抗体快速检测试剂条(RK39)或骨髓涂片对四川省疾病预防控制中心预防医学门诊部2020—2023年接诊的内脏利什曼原虫病疑似病例进行诊断,收集RK39检测或骨髓涂片阳性指标,采用Excel 2020软件对病例进行描述性流行病学分析。结果 2020—2023年四川省疾病预防控制中心共接诊内脏利什曼原虫病疑似病例325人,确诊36例,阳性率为11.08%。内脏利什曼原虫病男女发病性别比为11∶1;病例分布主要在九寨沟县和黑水县,分别占总病例数的19.44%和11.11%;病例主要以50岁以上农民为主,18岁以下少年儿童病例占比较少;春季、夏季、秋季和冬季内脏利什曼原虫病阳性率分别为10.11%、11.90%、12.99%和9.33%。36例病例中初诊时,仅12例在当地医疗机构确诊为内脏利什曼原虫病,误诊率为66.67%。结论 内脏利什曼原虫病容易误诊和漏诊,应进一步提升基层医疗机构的诊疗水平,长期加强疫区白蛉的防控,加强疫区易感人群的健康教育和防护。Objective To analyze the epidemiological characteristics of cases diagnosed with visceral leishmaniasis in the outpatient department of Sichuan Center of Disease Control and Prevention from 2020 to 2023,and to provide basis for optimizing control measures of visceral leishmaniasis in Sichuan.Methods Suspected cases of leishmania were diagnosed by using the rapid detection reagent strip of visceral leishmaniasis antibody(RK39)or bone marrow smears.Positive indicators of RK39 test or bone marrow smears were collected,and descriptive epidemiological analysis of cases was performed by using Excel 2020.Results From 2020 to 2023,325 suspected cases of leishmania were admitted to the outpatient department of the Centers for Disease Control and Prevention,with 36 confirmed cases and an average positive rate of 11.08%.The gender ratio of male to female onset was 11∶1.The positive cases were mainly distributed in Jiuzhaigou County and Heishui County,accounting for 19.44%and 11.11%of the infected population,respectively.The cases were mainly farmers aged over 50 years,and children under 18 years old accounted for less.The positive rates of visceral leishmaniasis in Spring,Summer,Autumn and Winter were 10.11%,11.90%,12.99%,and 9.33%,respectively.Among the 36 cases,only 12 cases were diagnosed as visceral leishmaniasis at the first visit in local medical institutions,with a rate of misdiagnosis being 66.67%.Conclusions Visceral leishmaniasis is prone to misdiagnosis and missed diagnosis.It′s necessary to further improve the diagnosis and treatment level of grassroots medical institutions,strengthen the prevention and control of sandflies in epidemic areas in long term,and strengthen health education and protection for susceptible populations in epidemic areas.

关 键 词：内脏利什曼原虫病 流性特征 四川地区 

分 类 号：R531.6[医药卫生—内科学]