Abstract：
OBJECTIVE: To analyze the epidemiological characteristics of leptospirosis in China from 2010 to 2022, so as to provide insights into formulation of the leptospirosis control strategy.
METHODS: All data pertaining to clinically diagnosed cases and confirmed cases of leptospirosis reported in China from January 1, 2010 to December 31, 2022 was collected from Chinese Disease Prevention and Control Information Management System. The spatial, temporal and population distributions, and report and diagnosis institutions of leptospirosis cases were analyzed using a descriptive epidemiological method.
RESULTS: A total of 4 559 leptospirosis cases were reported in China from 2010 to 2022, with an annual average number of 351 cases, and the number of reported leptospirosis cases reduced from 679 cases in 2010 to 158 cases in 2018. A total of 4 276 leptospirosis cases were reported in Sichuan Province, Yunnan Province, Guangdong Province, Hunan Province, Fujian Province, Zhejiang Province, Guangxi Zhuang Autonomous Region, Anhui Province, Jiangxi Province and Guizhou Province, accounting for 93.79% of the total number of leptospirosis cases in China. The number of leptospirosis cases had recently appeared a remarkable decline in Yunnan Province, while a significant rise was seen in the number of leptospirosis cases in two provinces of Zhejiang and Guangdong. No leptospirosis cases were reported in Henan Province from 2010 to 2020; however, there were 5 cases and 2 cases reported in 2021 and 2022, respectively. There was only one leptospirosis case reported in Shaanxi Province from 2010 to 2017; however, leptospirosis cases were reported in the province for 5 consecutive years since 2018. Leptospirosis cases were reported throughout the year in China from 2010 to 2022, with the peak of incidence found during the period between August and October, and the peak of leptospirosis incidence varied in provinces. A higher number of leptospirosis cases was seen among men than among women, with a male to female ratio of 2.3:1, and the median age of leptospirosis cases was 50 years (interquartile range, 23 years), with the highest proportion of leptospirosis cases reported at ages of 51 to 60 years (23.21%). Among all reported leptospirosis cases, 53.28% were confirmed cases, and the proportion of confirmed cases increased from 35.05% in 2010 to 61.66% in 2022. In addition, there were 67.22% of leptospirosis cases (2 937 cases) reported by comprehensive hospitals, 20.44% (893 cases) by disease control and prevention institutions, 7.23% (316 cases) by grassroots healthcare institutions and 5.10% (223 cases) by other healthcare and medical institutions, and the mortality of reported leptospirosis cases was 1.07% in China from 2010 to 2022, with a higher mortality seen among men than among women (1.39% vs. 0.36%; χ2 = 9.52, P = 0.002).
CONCLUSIONS: The incidence of leptospirosis remained at a low level in China from 2010 to 2022, and southern China was still the main endemic area for leptospirosis. The epidemiological characteristics of leptospirosis cases varied in endemic provinces, and leptospirosis cases had been continued to be reported in Shaanxi and Henan provinces, which should be paid much attention to. Intensified surveillance of leptospirosis, improved diagnosis and treatment capability of leptospirosis cases and leptospirosis control with adaptations to local circumstance are recommended.
［摘要］ 目的 分析 2010—2022 年我国钩端螺旋体病流行病学特征, 为制订钩端螺旋体病防控策略提供参考依据。方法 在中国疾病预防控制信息系统中, 收集 2010 年 1 月 1 日至 2022 年 12 月 31 日报告的钩端螺旋体病临床诊断病例和确 诊病例信息, 采用描述性流行病学方法对病例地区、时间、人群分布及报告和诊断机构进行分析。结果 2010—2022 年 全国累计报告钩端螺旋体病病例 4 559 例, 年均报告 351 例; 报告病例数从 2010 年的 679 例下降至 2018 年的 158 例。四 川省、云南省、广东省、湖南省、福建省、浙江省、广西壮族自治区、安徽省、江西省和贵州省累计报告钩端螺旋体病病例 4 276 例, 占全国病例总数的 93.79%; 其中云南省近年病例数大幅下降, 浙江省、广东省报告病例数明显增加。2010—2020 年河南省无钩端螺旋体病病例报告, 但 2021、2022 年分别报告 5 例和 2 例; 2010—2017 年陕西省仅报告 1 例病例, 但 自 2018 年起连续 5 年有病例报告。全国全年均有钩端螺旋体病病例报告, 以 8—10 月为发病高峰, 各省发病高峰存在差 异; 男性病例多于女性, 男女性别比为 2.3:1; 病例中位年龄 50 岁 (四分位间距: 23 岁), 以 51～60 岁组报告病例数占比最 高 (23.21%)。2010—2022 年我国钩端螺旋体病报告病例中, 确诊病例占 53.28%, 确诊病例占比从 2010 年的 35.05% 上升 至 2022 年的 61.66%。综合医院、疾病预防控制机构、基层卫生机构和其他卫生机构钩端螺旋体病报告病例数占比分别 为 67.22% (2 937 例)、20.44% (893 例)、7.23% (316 例)、5.10% (223 例)。2010—2022 年全国钩端螺旋体病报告病例病死 率为1.07%, 男性病死率高于女性 (1.39% vs. 0.36%; χ2 = 9.52, P = 0.002)。结论 2010—2022 年我国钩端螺旋体病处于 低水平流行状态, 南方地区为主要流行区, 各流行省份病例流行病学特征存在差异。陕西省、河南省等省份近年持续有 病例报告, 需加强关注。建议各地加强钩端螺旋体病监测, 提升病例诊治能力, 因地制宜开展防控工作。.
METHODS: All data pertaining to clinically diagnosed cases and confirmed cases of leptospirosis reported in China from January 1, 2010 to December 31, 2022 was collected from Chinese Disease Prevention and Control Information Management System. The spatial, temporal and population distributions, and report and diagnosis institutions of leptospirosis cases were analyzed using a descriptive epidemiological method.
RESULTS: A total of 4 559 leptospirosis cases were reported in China from 2010 to 2022, with an annual average number of 351 cases, and the number of reported leptospirosis cases reduced from 679 cases in 2010 to 158 cases in 2018. A total of 4 276 leptospirosis cases were reported in Sichuan Province, Yunnan Province, Guangdong Province, Hunan Province, Fujian Province, Zhejiang Province, Guangxi Zhuang Autonomous Region, Anhui Province, Jiangxi Province and Guizhou Province, accounting for 93.79% of the total number of leptospirosis cases in China. The number of leptospirosis cases had recently appeared a remarkable decline in Yunnan Province, while a significant rise was seen in the number of leptospirosis cases in two provinces of Zhejiang and Guangdong. No leptospirosis cases were reported in Henan Province from 2010 to 2020; however, there were 5 cases and 2 cases reported in 2021 and 2022, respectively. There was only one leptospirosis case reported in Shaanxi Province from 2010 to 2017; however, leptospirosis cases were reported in the province for 5 consecutive years since 2018. Leptospirosis cases were reported throughout the year in China from 2010 to 2022, with the peak of incidence found during the period between August and October, and the peak of leptospirosis incidence varied in provinces. A higher number of leptospirosis cases was seen among men than among women, with a male to female ratio of 2.3:1, and the median age of leptospirosis cases was 50 years (interquartile range, 23 years), with the highest proportion of leptospirosis cases reported at ages of 51 to 60 years (23.21%). Among all reported leptospirosis cases, 53.28% were confirmed cases, and the proportion of confirmed cases increased from 35.05% in 2010 to 61.66% in 2022. In addition, there were 67.22% of leptospirosis cases (2 937 cases) reported by comprehensive hospitals, 20.44% (893 cases) by disease control and prevention institutions, 7.23% (316 cases) by grassroots healthcare institutions and 5.10% (223 cases) by other healthcare and medical institutions, and the mortality of reported leptospirosis cases was 1.07% in China from 2010 to 2022, with a higher mortality seen among men than among women (1.39% vs. 0.36%; χ2 = 9.52, P = 0.002).
CONCLUSIONS: The incidence of leptospirosis remained at a low level in China from 2010 to 2022, and southern China was still the main endemic area for leptospirosis. The epidemiological characteristics of leptospirosis cases varied in endemic provinces, and leptospirosis cases had been continued to be reported in Shaanxi and Henan provinces, which should be paid much attention to. Intensified surveillance of leptospirosis, improved diagnosis and treatment capability of leptospirosis cases and leptospirosis control with adaptations to local circumstance are recommended.
［摘要］ 目的 分析 2010—2022 年我国钩端螺旋体病流行病学特征, 为制订钩端螺旋体病防控策略提供参考依据。方法 在中国疾病预防控制信息系统中, 收集 2010 年 1 月 1 日至 2022 年 12 月 31 日报告的钩端螺旋体病临床诊断病例和确 诊病例信息, 采用描述性流行病学方法对病例地区、时间、人群分布及报告和诊断机构进行分析。结果 2010—2022 年 全国累计报告钩端螺旋体病病例 4 559 例, 年均报告 351 例; 报告病例数从 2010 年的 679 例下降至 2018 年的 158 例。四 川省、云南省、广东省、湖南省、福建省、浙江省、广西壮族自治区、安徽省、江西省和贵州省累计报告钩端螺旋体病病例 4 276 例, 占全国病例总数的 93.79%; 其中云南省近年病例数大幅下降, 浙江省、广东省报告病例数明显增加。2010—2020 年河南省无钩端螺旋体病病例报告, 但 2021、2022 年分别报告 5 例和 2 例; 2010—2017 年陕西省仅报告 1 例病例, 但 自 2018 年起连续 5 年有病例报告。全国全年均有钩端螺旋体病病例报告, 以 8—10 月为发病高峰, 各省发病高峰存在差 异; 男性病例多于女性, 男女性别比为 2.3:1; 病例中位年龄 50 岁 (四分位间距: 23 岁), 以 51～60 岁组报告病例数占比最 高 (23.21%)。2010—2022 年我国钩端螺旋体病报告病例中, 确诊病例占 53.28%, 确诊病例占比从 2010 年的 35.05% 上升 至 2022 年的 61.66%。综合医院、疾病预防控制机构、基层卫生机构和其他卫生机构钩端螺旋体病报告病例数占比分别 为 67.22% (2 937 例)、20.44% (893 例)、7.23% (316 例)、5.10% (223 例)。2010—2022 年全国钩端螺旋体病报告病例病死 率为1.07%, 男性病死率高于女性 (1.39% vs. 0.36%; χ2 = 9.52, P = 0.002)。结论 2010—2022 年我国钩端螺旋体病处于 低水平流行状态, 南方地区为主要流行区, 各流行省份病例流行病学特征存在差异。陕西省、河南省等省份近年持续有 病例报告, 需加强关注。建议各地加强钩端螺旋体病监测, 提升病例诊治能力, 因地制宜开展防控工作。.
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