Yang Chengyun, Li Suhua, Lu Deling, He Zhiquan, Wang Dan, Qian Dan, Liu Ying, Zhou Ruimin, Ji Penghui, Chen Jun-Hu, Zhang Hongwei
Department of Parasite Disease Control and Prevention, Henan Center for Disease Control and Prevention, Zhengzhou 450016, China.
Henan Provincial Medical Key Laboratory of Parasitic Pathogen and Vector, No. 105 South Agricultural Road Zhengdong New District, Zhengzhou 450016, China.
Trop Med Infect Dis. 2023 Jun 12;8(6):318. doi: 10.3390/tropicalmed8060318.
Visceral leishmaniasis (VL) was widely prevalent in Henan Province in the 1950s. Through active efforts by the government, there were no local cases reported from 1984 to 2015. In 2016, local VL cases reoccurred, and there was an increasing trend of VL cases in Henan Province. To provide a scientific control of VL, an investigation was conducted in Henan Province from 2016 to 2021. The data from VL cases were obtained from the Disease Surveillance Reporting System of the Chinese Center for Disease Control and Prevention. The rK39 immunochromatographic test (ICT) and PCR assay were performed among high-risk residents and all dogs in the patients' village. ITS1 was amplified, sequenced, and subjected to phylogenetic analyses. A total of 47 VL cases were reported in Henan Province during 2016-2021. Of the cases, 35 were local, and they were distributed in Zhengzhou, Luoyang, and Anyang. The annual average incidence was 0.008/100,000, showing an upward trend year by year (χ = 3.987, = 0.046). Their ages ranged from 7 months to 71 years, with 44.68% (21/47) in the age group of 0-3 years and 46.81% (22/47) in the age group ≥15 years. The cases occurred throughout the year. The high-risk populations were infants and young children (age ≤3), accounting for 51.06% (24/47), followed by farmers at 36.17% (17/47). The ratio of males to females was 2.13:1. The positive rates of rK39 ICT and PCR were 0.35% (4/1130) and 0.21% (1/468) in the residents. The positive rates of rK39 ICT and PCR were 18.79% (440/2342) and 14.92% (139/929) in the dogs. The ITS1 amplification products in the patients and positive dogs were sequenced. The homology between the target sequence and was more than 98%. The phylogenetic analysis indicated that the patients and the positive dogs were infected by the same type of , which was consistent with the strains in the hilly endemic areas in China. This paper showed that patients and domestic dogs were infected by the same type of and that the positive rate in dogs was relatively high in Henan Province. Because the measures of patient treatment and culling of infected dogs were not effective in reducing VL incidence in Henan Province, it is urgent to develop new approaches for the control of VL, such as wearing insecticide-impregnated collars on dogs, treating the positive dogs, spraying insecticide for sandflies control, and improving residents' self-protection awareness to prevent the further spread of VL in Henan Province.
内脏利什曼病（VL）在20世纪50年代曾在河南省广泛流行。通过政府的积极努力，1984年至2015年期间未报告本地病例。2016年，本地VL病例再次出现，且河南省VL病例呈上升趋势。为科学防控VL，于2016年至2021年在河南省开展了一项调查。VL病例数据来自中国疾病预防控制中心的疾病监测报告系统。对高危居民和患者所在村庄的所有犬只进行了rK39免疫层析试验（ICT）和PCR检测。对ITS1进行扩增、测序并进行系统发育分析。2016年至2021年期间，河南省共报告47例VL病例。其中35例为本地病例，分布在郑州、洛阳和安阳。年平均发病率为0.008/10万，呈逐年上升趋势（χ = 3.987，P = 0.046）。他们的年龄从7个月到71岁不等，0至3岁年龄组占44.68%（21/47），≥15岁年龄组占46.81%（22/47）。病例全年均有发生。高危人群为婴幼儿（年龄≤3岁），占51.06%（24/47），其次是农民，占36.17%（17/47）。男女比例为2.13:1。居民中rK39 ICT和PCR的阳性率分别为0.35%（4/1130）和0.21%（1/468）。犬只中rK39 ICT和PCR的阳性率分别为18.79%（440/2342）和14.92%（139/929）。对患者和阳性犬只的ITS1扩增产物进行了测序。目标序列与[具体参照序列]的同源性超过98%。系统发育分析表明，患者和阳性犬只感染的是同一种[利什曼原虫种类]，与中国丘陵流行区的菌株一致。本文表明患者和家犬感染的是同一种[利什曼原虫种类]，且河南省犬只的阳性率相对较高。由于患者治疗和扑杀感染犬只的措施在降低河南省VL发病率方面效果不佳，迫切需要开发新的VL防控方法，如给犬只佩戴浸有杀虫剂的项圈、治疗阳性犬只、喷洒杀虫剂以控制白蛉，以及提高居民的自我保护意识，以防止VL在河南省进一步传播。
