| 沈建平,张国成,陈祥生,周敏,余美文,严良斌.中国1949-2007年消除麻风病的历程及其流行特征[J].Chinese journal of Epidemiology,2008,29(11):1095-1100 |
| 中国1949-2007年消除麻风病的历程及其流行特征 |
| A long-term evolution on the epidemiological characteristics of leprosy, towards the goal of its elimination in 1949-2007 in China |
| Received:July 15, 2008 |
| DOI： |
| KeyWord: 麻风病 监测 基本消除 |
| English Key Word: Leprosy Surveillance Basic elimination of leprosy |
| FundProject: |
| Author Name | Affiliation | | SHEN Jian-ping | Department of Leprosy Control, Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing 210042, China | | ZHANG Guo-chen | Department of Leprosy Control, Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing 210042, China | | CHEN Xiang-sheng | Department of Leprosy Control, Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing 210042, China | | ZHOU Min | Department of Leprosy Control, Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing 210042, China | | YU Mei-wen | Department of Leprosy Control, Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing 210042, China | | YAN Liang-bin | Department of Leprosy Control, Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing 210042, China |
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| Abstract: |
| 目的 分析中国50多年麻风病防治进程中的一些流行病学规律和特征,为加快彻底消除麻风病提供经验.方法 利用全国麻风疫情监测系统,获得每年由基层防治机构,上报的资料,进行系统回顾分析.结果 1949-2007年全国累计报告麻风病患者487 900例.发现率从最高1958年的5.56/10万下降到2007年的0.12/10万.患者主要分布在云南、贵州、四川、广东、广西、湖南、江西等省(自治区)气候温暖湿润且经济较为落后的山区.经过50多年的积极防治,中国东部和南部沿海省份麻风病的发现率下降幅度较大,而西部和西南省份下降幅度缓慢.每年复发病例数与新发现病例数的比从1960年代的1:139上升到1980年代后的1:10左右.儿童麻风病发现比例从1968年以后到现在一直波动在3%～4%.近20年新发病例皮肤查菌阳性率不断上升,2级畸残率波动在20%以上.在东部省份新诊断的病例中,已经含有一些从西南省份迁入或以后发病的患者.结论 随着社会经济发展,加之持久的积极防治,麻风病的流行会逐渐缓慢下降,但需要一个漫长的过程,一些重大事件作为负面因素会引起病例发现趋势的波动. |
| English Abstract: |
| Objective To understand the epidemiologicsl characteristics of leprosy during the evolution of the disease, towards the goal of elimination for the past 50 years and longer, so as to provide experiences for aecelerating eradication of leprosy in China. Methods Data were collected from National Surveillance System of Leprosy which was composed annually of all the data from county-based leprosy unit reporting system. All the data were reviewed retrospectively. Results A total number of 487 900 leprosy patients were reported from 1949 to 2007 in China. The ease detection rate reduced from the highest of 5.561100 000 in 1958 to the lowest of 0.12/100 000 in 2007. Leprosy patients mainly distributed in mountain areas in Yunnan, Guizhou, Sichuan, Guangdong Guangxi, Hunan and Jiangxi provinces with warm and damp climate and underdeveloped economy. After more than 50 years of leprosy control efforts,the case detection rate declined quickly in provinces in the eastern and the southern parts but very slowly in provinces in the western and the southwestern part of China. The ratio of relapsed patients to newly detected ones increased from 1:139 in 1960s' to 1:10 after 1980s', annually. The proportion of child cases among newly detected patients had been 3 %-4 % since 1968. In the recent 20 years, the proportion of new patients with positive skin smear gradually increased and the rate of disability grade two reached 20 % and more. The average age of new patients upon diagnosis was 45 years old in the east coastal provinces but only 38 years old in the southwest provinces. A new finding was that some new patients detected in the east coastal provinces were immigrants from the southwestern provinces. Conclusion With continuous socio-economic development and active efforts on leprosy control, the prevalence of leprosy gradually declined despite the long evolution period. Some negative events seemed to have influenced the trend of case detection. |
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