斯维尔德洛夫斯克地区近20年莱姆病流行过程特征

Н. М. Колясникова, Л. Г. Чистякова, А. В. Пономарева, А. Е. Платонов, В. В. Романенко, Татьяна Александровна Чеканова, А. В. Титков, А. А. Ишмухаметов, В. Г. Акимкин, NM Kolyasnikova, LG Chistyakova, AV Ponomareva, AE Platonov, VV Romanenko, TA Chekanova, A. Titkov, AA Ishmukhametov, VG Akimkin
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To characterize the epidemic process of LB in the territory of the Sverdlovsk district over a 20-year period (2002–2021).Materials and methods. The paper uses data from federal and regional statistical observations, reporting materials of the Department of Rospotrebnadzor in the Sverdlovsk district for 2002–2021, methods of statistical analysis.Results and discussion. During the follow–up period (2002–2021), the incidence rate of BL in the Sverdlovsk district exceeded the average long-term level in the Russian Federation by almost 3 times, and in the Ural Federal region – by 1.8 times. Among the mechanisms and ways of transmission of LB pathogens, the vector-borne mechanism dominated (84.5%), the share of the unidentified pathway was 15.4%, alimentary (when using raw goat's milk) – 0.1%. The duration of the epidemic season for LB in the district was 10 months (from March to December) with a peak incidence in June. 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引用次数: 0

摘要

的相关性。斯维尔德洛夫斯克地区是莱姆病(LB)紧张的自然重灾区,在俄罗斯联邦和乌拉尔联邦州,不断有记录的发病率多次超过这些指标。LB在本区59个行政地区中的56个地区注册。目前,俄罗斯联邦的LB计数既包括伯氏疏螺旋体(Borrelia burgdorferi senu lato)组的感染,也包括宫本疏螺旋体(Borrelia miyamotoi senu lato)组的感染。描述斯维尔德洛夫斯克地区20年期间(2002-2021年)LB流行过程。材料和方法。本文使用的数据来自联邦和地区统计观察,2002-2021年斯维尔德洛夫斯克地区Rospotrebnadzor部门的报告材料,统计分析方法。结果和讨论。在随访期间(2002-2021年),斯维尔德洛夫斯克地区的BL发病率超过俄罗斯联邦平均长期水平近3倍,乌拉尔联邦州的发病率超过1.8倍。在LB病原体的传播机制和途径中,媒介传播机制占主导地位(84.5%),未知途径占15.4%,食物(使用生羊奶时)- 0.1%。疫区LB流行季节为10个月(3 - 12月),6月为发病高峰。LB病例在不同年龄人群中均有记录,以60岁及以上人群为主(39.1%)。根据社会构成对LB患者分布的分析表明,其中养老金领取者占36.3%,官员占27.8%,失业者占14.1%。在这些病例中,注意到学童和7岁以下儿童的比例很高。结果发现,该地区LB有红斑型和非红斑型,以红斑型为主(64.5%)。红斑型主要病原为加里尼伯氏疏螺旋体,非红斑型主要病原为宫本氏疏螺旋体和加里尼伯氏疏螺旋体。在总体发病结构中,LB病例数主要由城市居民决定(92.9%)。在研究期间,本区境内未发生致人死亡的LB病例。由于全球缺乏LB疫苗接种,降低LB发病率的唯一策略是非特异性预防和及时诊断,包括流行病学史、临床和实验室诊断数据。我们在斯维尔德洛夫斯克地区进行的长期临床、流行病学和实验室研究使我们能够确定LB流行过程的主要表现,并改善疾病的诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Characteristics of the epidemic process of Lyme borreliosis in the Sverdlovsk district over a 20-year period
Relevance. The Sverdlovsk district is a tense natural focus for Lyme borreliosis (LB) with a constantly recorded incidence that exceeds these indicators in the Russian Federation and the Ural Federal region several times. LB is registered on 56 of 59 administrative territories of the district. Currently, the count of LB in the Russian Federation includes both infections caused by Borrelia burgdorferi sensu lato group Borrelia and infections caused by Borrelia miyamotoi sensu lato group Borrelia.Aim. To characterize the epidemic process of LB in the territory of the Sverdlovsk district over a 20-year period (2002–2021).Materials and methods. The paper uses data from federal and regional statistical observations, reporting materials of the Department of Rospotrebnadzor in the Sverdlovsk district for 2002–2021, methods of statistical analysis.Results and discussion. During the follow–up period (2002–2021), the incidence rate of BL in the Sverdlovsk district exceeded the average long-term level in the Russian Federation by almost 3 times, and in the Ural Federal region – by 1.8 times. Among the mechanisms and ways of transmission of LB pathogens, the vector-borne mechanism dominated (84.5%), the share of the unidentified pathway was 15.4%, alimentary (when using raw goat's milk) – 0.1%. The duration of the epidemic season for LB in the district was 10 months (from March to December) with a peak incidence in June. Cases of LB were registered among people of different ages, with a predominance in the group of 60 years and older (39.1%). An analysis of the distribution of people with LB by social composition showed that pensioners prevailed among them – 36.3%, officials made up 27.8%, unemployed – 14.1%. Among the cases, a high proportion of schoolchildren and children under 7 years old were noted. It was found that erythematous and non-erythematous forms of LB are registered in the district, with a predominance of erythematous (64.5%). The main etiological agent of the erythematous form is Borrelia garinii, while the non-erythematous form is Borrelia miyamotoi and B. garinii. In the general structure of morbidity, the number of cases of LB is largely determined by the city inhabitants (92.9%). There were no fatal outcomes in LB in the territory of the district during the studied period.Conclusions. Due to the lack of vaccination of LB worldwide, the only strategy to reduce the incidence of LB is non-specific prevention and timely diagnosis of the disease, including data from epidemiological history, clinical and laboratory diagnostics. The long-term clinical and epidemiological and laboratory studies conducted by us in the Sverdlovsk district allowed us to characterize the main manifestations of the epidemic process of LB and to improve the diagnosis of the disease.
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