新疆维吾尔自治区伽师县卧里托格拉克乡居民内脏利什曼病流行现况调查

目的 调查新疆维吾尔自治区伽师县内脏利什曼病流行现况.方法 采用回顾性调查和现况调查相结合,对伽师县卧里托格拉克乡20村1组所有居民进行入户调查.调查内容包括既往有无疑似内脏利什曼病病史,部分居民进行利什曼素皮内试验,对3岁以下婴幼儿皮内试验阴性者进行查体(触诊肝、脾)和rk39免疫层析试条检测.在居民住宅内、外捕集白蛉,解剖鉴定并检查前鞭毛体有无自然感染.结果 接受利什曼素皮内试验149人,阳性率为68.46%(102/149);3岁以下年龄组阳性率为11.76%(2/17),4～75岁年龄组阳性率为75.76%(100/132).3岁以下年龄组皮内试验阴性者有15人接受rk39免疫层析试条检测,1例阳性者(女,1岁),确认为临床诊断病例.2001-2008年7月有既往病史者52例,其中治愈50例,死亡2例.捕获的374只雌蛉,经解剖鉴定为吴氏白蛉(Phlebotomus wui),其中3只雌蛉体内查见自然感染的利什曼原虫前鞭毛体.结论 伽师县仍有内脏利什曼病流行.

An epidemiological survey of visceral leishmaniasis in Gholtoghrakh Township of Payzawat County of Xinjiang Uygur Autonomous Region

Objective To investigate the epidemiological status of visceral leishmaniasis in Payzawat County of Xinjiang Uygur Autonomous Region. Methods Based on a hint of possible existence of patients, a retrospective survey was carried out house by house to find cases with suspected signs/symptoms of the disease,meanwhile, a survey on current status was conducted, including physical examination (liver and spleen palpation) on those less than 3 years old, leishmanin skin test and rk39 immunochromatographic strip test on part of the residents. Bone marrow smears were examined for the cases with clinical signs/symptoms and positive rk39 strip test. Sandflies were collected using routine methods in and around the area, identified, and dissected to find infection of promastigotes. Results Leishmanin skin test was performed in 149 people with a positive rate of 68.46% (102/149) among them a positive rate of 11.76% (2/17) under 3 years old and a positive rate of 75.76% (100/132) between 4-75 years old. Of the 15 children under 3 years old with a negative skin test,one showed positive for rk39 strip test, and so confirmed as visceral leishmaniasis. There were 52 cases with a history of suspected signs/symptoms including 2 deaths, traced back as visceral leishmaniasis in 2001-2008.Total 374 sandfies were identified as Phlebotomus wui, and natural infection with promastigotes was found in 3 sandfies. Conclusion Visceral leishmaniasis is still prevalence in Payzawat County.