尼泊尔内脏利什曼病四十年（1980-2019）：趋势和消除挑战。

Forty years (1980-2019) of visceral leishmaniasis in Nepal: trends and elimination challenges.

机构信息

Central Departm ent of Zoology, Institute of Science and Technology, Tribhuvan University, Kathmandu 44060, Nepal.

Central Department of Microbiology, Institute of Science and Technology, Tribhuvan University, Kathmandu 44618, Nepal.

出版信息

Trans R Soc Trop Med Hyg. 2023 Jun 2;117(6):460-469. doi: 10.1093/trstmh/trad001.

DOI:10.1093/trstmh/trad001

PMID:36715092

Abstract

BACKGROUND

Visceral leishmaniasis (VL) is an important re-emerging neglected tropical disease associated with poverty. Despite the elimination initiative started in 2005, VL cases have been expanding into geographic areas in Nepal. The present study aims at exploring the trends of VL from 1980 to 2019.

METHODS

This retrospective analysis covers 40 y of VL cases reported by the Epidemiology Diseases Control Division, Nepal. Subgroup analyses for annual incidence were performed by age, sex, seasons, districts and provinces, and VL cases were visualized on in-country maps.

RESULTS

A total of 34 564 cases and 584 deaths of VL were reported during 1980-2019. VL persistently increased until 2006 and was reported from all seven provinces of the country. The highest number of confirmed cases (n=2229) was reported in 2003 and the lowest (n=60) in 1983. VL cases expanded from 12 to 23 endemic districts. The key components of the VL elimination program are early diagnosis; enhanced surveillance; integrated vector management; social mobilization; research and treatment.

CONCLUSIONS

Expansion of VL towards the hilly and mountain regions of Nepal has posed challenges to the elimination program. Urgent VL control measures are required to achieve the elimination goals.

摘要

背景

内脏利什曼病（VL）是一种与贫困相关的重要新兴被忽视热带病。尽管自 2005 年开始实施消除倡议，但 VL 病例已扩展到尼泊尔的地理区域。本研究旨在探讨 1980 年至 2019 年 VL 的趋势。

方法

本回顾性分析涵盖了尼泊尔流行病学疾病控制司报告的 40 年来的 VL 病例。按年龄、性别、季节、地区和省份对年度发病率进行了分组分析，并在国内地图上可视化了 VL 病例。

结果

1980-2019 年共报告了 34564 例 VL 病例和 584 例死亡。VL 持续增加，直到 2006 年，并且在该国的七个省份都有报告。2003 年报告的确诊病例数最多（n=2229），1983 年报告的病例数最少（n=60）。VL 病例从 12 个流行区扩展到 23 个流行区。VL 消除计划的关键组成部分包括早期诊断、加强监测、综合病媒管理、社会动员、研究和治疗。