Department of Epidemiology, Faculty of Medicine, Comenius University, 813 72, Bratislava, Slovak Republic.
Eur J Clin Microbiol Infect Dis. 2012 Sep;31(9):2167-76. doi: 10.1007/s10096-012-1551-8. Epub 2012 Feb 23.
The purpose of this study was the observation of eventual shifts in some basic epidemiological features of human leptospirosis in Slovakia over a long period of time. Epidemiological traits of human leptospirosis were evaluated in three decades: 1954-1963 (822 cases), 1976-1985 (477 cases) and 1997-2006 (310 cases). The evaluation encompassed the aetiologic structure of cases, the incidence rate of diseases, men-to-women ratio of patients, as well as the professional and seasonal distribution of patients. The most affected feature was the incidence rate, which decreased by more than 70% over time. Another considerable change was the proportion of different major serological types of leptospirosis. The initially prevailing Sejroe infections fell to 4th place in the percentage rank, while Grippotyphosa disease, which was ranked 2nd place at the beginning of the observations, became dominating. Icterohaemorrhagiae disease climbed from 4th place to 2nd place. Third place was reserved by the Pomona + Tarassovi infections during the whole study period. A distinct tendency of age- and gender-specific incidence rate compared to the proportion of leptospirosis by age and gender was noticed; only minor alterations of the values of both parameters were registered over time. The overall value of the men-to-women ratio (MWR) of diseased persons was virtually within the same range in all three time periods but varied according to different age groups. The MWRs relative to the causal Leptospira serovars were stable over time but markedly differed among distinct serovars. Incidence rates related to age and aetiology showed different trends for the major serological types of leptospirosis. Changes were observed in the professional distribution of leptospirosis: there was an important proportional decrease of cases among farmers and field workers, an increase among house-wives + pensioners, but only some slight changes in abattoir workers/butchers, pupils + students and workers. The seasonal distribution of patients did not show any remarkable changes; the maximum percentage of cases occurred during the period extending from July to November during the whole period of observation. The epidemiological features of human leptospirosis underwent important shifts in the Slovak Republic over a 50-year period of time. They were very closely related to economical, social and political changes, which are discussed in this paper. The results may be useful for specialists in other European countries.
本研究的目的是观察斯洛伐克人类钩端螺旋体病的一些基本流行病学特征在长时间内的变化。对人类钩端螺旋体病的流行病学特征进行了三十年的评估：1954-1963 年（822 例）、1976-1985 年（477 例）和 1997-2006 年（310 例）。评估包括病例的病因结构、疾病发病率、男女患者比例以及患者的职业和季节性分布。受影响最大的特征是发病率，随着时间的推移下降了 70%以上。另一个重要的变化是不同主要血清型钩端螺旋体病的比例。最初流行的 Sejroe 感染下降到第 4 位，而在观察开始时排名第 2 位的 Grippotyphosa 疾病成为主导。Icterohaemorrhagiae 疾病从第 4 位上升到第 2 位。在整个研究期间，Pomona + Tarassovi 感染占据第 3 位。注意到年龄和性别特异性发病率与年龄和性别相关的钩端螺旋体病比例之间明显的趋势；随着时间的推移，两个参数的值仅略有变化。在所有三个时期，患病者的男女比例（MWR）的总体值几乎相同，但根据不同的年龄组而有所不同。与因果 Leptospira 血清型相关的 MWR 相对稳定，但在不同血清型之间有明显差异。与年龄和病因相关的发病率显示出不同的趋势，主要血清型的钩端螺旋体病有所不同。钩端螺旋体病的职业分布发生了变化：农民和田间劳动者的病例比例显著下降，家庭主妇+退休人员的病例比例增加，但屠宰场工人/屠夫、学生和工人的病例比例仅略有变化。患者的季节性分布没有显示出任何明显的变化；在整个观察期间，7 月至 11 月期间的病例百分比最高。在斯洛伐克共和国，人类钩端螺旋体病的流行病学特征在 50 年的时间里发生了重要变化。这些变化与经济、社会和政治变化密切相关，本文对此进行了讨论。这些结果可能对欧洲其他国家的专家有用。
