| Objective: To analyze the epidemiological characteristics and spatio-temporal clustering characteristics of leishmaniasis in Xinjiang province and Construction Corps,explore the relevant factors affecting the incidence of leishmaniasis,and to provide evidences for implementing surveillance and prevention of the disease.Methods:(1)We analyzed the distribution characteristics of leishmaniasis from 2004 to 2018 in Xinjiang province and Construction Corps,and calculated the incidence rate with SPSS 20.0 software.(2)In Sa TScan9.6 software,we calculated the incidence of leishmaniasis of every regiment and performed a space-time scan in the study area from 2004 to 2018.The space-time clustering area was superimposed on the geographic information database established by Arc GIS 10.2,and drawn the space-time clustering map.(3)We selected 50 th Regiment for a 1: 3 case-control analysis study,and performed conditional Logistic regression analysis on SPSS 20.0 software to calculate OR value and 95% confidence interval(95% CI).Results :(1)The Corps reported a total of 103 cases of leishmaniasis and one case died from 2004 to 2018,with an average annual incidence rate of 0.26 / 100000 and a cumulative mortality rate of 0.97%.From the monthly distribution of cases,the peak period was from October to December(48.54%).The affected population was mainly concentrated in the 0-3 year old scattered children and the male to female sex ratio was 1.51: 1.The reported cases in this area was distributed in 24 regiments of 9 divisions,with the Third Division having the largest number of cases(87.38%).The median time to onset of leishmaniasis in the Corps area from 2004 to 2018 was 9 days.(2)The number of cases reported by the Third Division from 2004 to 2018 was 90,with an average annual incidence of 2.83 / 100000 and a cumulative mortality rate of 1.11%.From the monthly distribution of cases,the number of reported cases in the 50 th Regiment and the Jiashi Farm were mostly in November(27.59%)and October to December(60%)respectively.The affected population was mainly concentrated in the 0-2 age scattered children and the male-to-female sex ratio was 1.25: 1.The cases of the Third Division were distributed in 11 regiments and mainly in the Jiashi Farm(38.89%)and the 50 th Regiment(32.22%).(3)Spatio-temporal clustering analysis shows that a meaningful gathering area is detected in the Corps area from 2005 to 2011,centered on the 48 th Regiment of the Third Division(39.43 N,78.20E),with a radius of 122.36km;Two meaningful space-temporal clusters are detected in The Third Division: the Jiashi Farm(39.68 N,77.59 E)and the 50 th Regiment(39.94 N,77.23 E);Two meaningful space-temporal clusters are detected in the cases distribution: one is the Jiashi Farm(39.68 N,77.59 E)of the Third Division from 2007 to 2010,another is 67 th Regiment(43.79 N,80.75 E)from 2005 to 2010.(4)The results of logistic regression analysis showed that the number of domestic animals,whether they had outdoor sleeping habits,and whether they used mosquito nets had statistical significance(P <0.05).Multi-factor logistic regression analysis results show that the use of mosquito nets was a protective factor(OR=0.158,95%CI:0.026~0.946),and outdoor sleeping habit was a risk factor(OR=6.451,95%CI:1.591~26.157).Conclusion:(1)The overall incidence of leishmaniasis in the Corps region from 2004 to 2018 was relatively low,but small-scale pulsed outbreaks still occurred every few years.The leishmaniasis cases were reported in 24 regiments of 9 divisions,but mainly concentrated in the Third Division.The incidence of scattered children aged 0-3 was relatively high.(2)Spatio-temporal cluster analysis results show that the incidence of leishmaniasis in the Corps area was not randomly distributed.High incidence risk and concentrated cases were in the gathering area.Outside the clustered area,the risk of disease was low,and the cases were distributed sparsely and discretely.(3)Having outdoor sleeping habits in the summer will increase the prevalence of desert-type kala-azar,and using mosquito nets in seasons with a large number of mosquitoes will reduce the risk of leishmaniasis. |
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