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目的调查新疆库尔勒市塔什店镇哈满沟煤矿内脏利什曼病的流行现况。方法2008年6月采用回顾性调查与现况调查相结合,对哈满沟矿区所有居民进行逐户入室调查。内容包括既往有无疑似内脏利什曼病病史,部分居民进行利什曼素皮内试验,并对15岁以下儿童皮内试验阴性者进行体检(肝、脾触诊)和rk39免疫层析试条检测,具备内脏利什曼病症状和体征、试条阳性者进行骨髓穿刺,镜检是否感染利什曼原虫无鞭毛体。在居民点及附近野外捕集白蛉,解剖鉴定白蛉,并检查前鞭毛体有无自然感染。结果接受利什曼素皮内试验185人,阳性39例,阳性率为21.1%(39/185)。在当地居住不足6年的成年人和在当地出生的5岁以下儿童共45人,均为阴性;在当地居住6年以上者阳性率为27.9%(39/140)。15岁以下儿童皮内试验阴性者(81人)接受rk39免疫层析试条检测,阳性1例,经骨髓穿刺镜检见利什曼原虫无鞭毛体,确诊为内脏利什曼病。捕获的12只白蛉,经剖检鉴定为亚历山大白蛉(Phlebotomus alexandri),其中1只雌蛉利什曼原虫前鞭毛体阳性。结论哈满沟矿区为内脏利什曼病流行区。
Objective To investigate the prevalence of visceral leishmaniasis in Hamanigou coal mine in Tashidian town, Korla city, Xinjiang. Methods In June 2008, a retrospective survey combined with current situation investigation was conducted to investigate all households in Haman ditch mining area by household. Including past history of suspected visceral leishmaniasis, some residents conducted in-depth Leishmanin test, and children under the age of 15 intradermal test negative for physical examination (liver and spleen palpation) and rk39 immunochromatographic test Article detection, with visceral leishmaniasis symptoms and signs, test-positive bone marrow biopsy, microscopic examination of Leishmania amastigotes. In the settlements and nearby wild catfish, catfish anatomical identification, and check whether the former spontaneous flagella body infection. Results Leishmanin skin test in 185 patients, 39 were positive, the positive rate was 21.1% (39/185). A total of 45 negative adults were found in adults with less than 6 years of local population and those under 5 years old locally. The positive rate was 27.9% (39/140) when they lived in the area for more than 6 years. Children under 15 years old with intradermal test (81) were tested by rk39 immunochromatographic test strips and 1 case was positive. Leishmania amastigotes were detected by bone marrow biopsy and diagnosed as visceral leishmaniasis. Twelve captured whiteflies were identified by autopsy as Phlebotomus alexandri, one of which was positive for promastigotes of Leishmania esculenta. Conclusion Haman ditch mine area is the predominant area of visceral leishmaniasis.