Aoun K, Jeddi F, Amri F, Ghrab J, Bouratbine A
Laboratoire de recherche 05-SP 03 parasitoses émergentes, Tunis, Tunisie.
Med Mal Infect. 2009 Oct;39(10):775-9. doi: 10.1016/j.medmal.2009.08.010. Epub 2009 Sep 30.
Visceral leishmaniasis is an important health problem in Tunisia. The aim of this study was to update the epidemiological and clinical features of the disease.
We performed a retrospective systematic sampling of epidemiological and clinical data collected from the medical records of 1,096 cases of visceral leishmaniasis diagnosed between 1996 and 2006 all over the country.
The mean annual incidence of cases was 99.6 cases/year. The mean annual incidence rate was 1.04 cases/100,000 inhabitants, showing an important increase compared to former studies. As expected, children under 5 years (866 cases) were the most affected with a mean annual incidence rate of 9.6 cases/100,000 (p<0.001). The geographical distribution of cases revealed the spreading of the disease from the Northern parts of the country to the Central and even to Southern ones. Rural cases (65.3%) were significantly more numerous than urban ones (34.7%), p<0.001. The sex ratio was 1.03. The diagnostic delay (average of 54 days) was considerably shortened during the study period compared to previous reports, and explains the decrease of the lethality rate (2.9%).
Visceral leishmaniasis has been present in central Tunisia since the early 1990 s. Its incidence and the distribution area have increased. This evolution is probably linked to the development of irrigation and agriculture favorable to the multiplication of vector sandflies and dogs reservoirs of Leishmania infantum.
内脏利什曼病是突尼斯一个重要的健康问题。本研究旨在更新该疾病的流行病学和临床特征。
我们对1996年至2006年期间在全国范围内诊断的1096例内脏利什曼病病例的病历中收集的流行病学和临床数据进行了回顾性系统抽样。
病例的年平均发病率为99.6例/年。年平均发病率为1.04例/10万居民，与以前的研究相比有显著增加。正如预期的那样，5岁以下儿童（866例）受影响最大，年平均发病率为9.6例/10万（p<0.001）。病例的地理分布显示该疾病从该国北部蔓延至中部甚至南部。农村病例（65.3%）明显多于城市病例（34.7%），p<0.001。性别比为1.03。与以前的报告相比，研究期间诊断延迟（平均54天）大幅缩短，这解释了致死率（2.9%）的下降。
自20世纪90年代初以来，突尼斯中部一直存在内脏利什曼病。其发病率和分布区域有所增加。这种演变可能与灌溉和农业的发展有关，灌溉和农业有利于传播媒介白蛉和婴儿利什曼原虫的犬类宿主的繁殖。
