Visceral Leishmaniasis — China, 2015−2019

Zhou, Zhengbin; Lyu, Shan; Zhang, Yi; Li, Yuanyuan; Li, Shi-Zhu; Zhou, Xiao‐Nong

doi:10.46234/ccdcw2020.173

Cited by 16 publications

(32 citation statements)

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“…As major parasitic diseases control has been reinforced by the central government of China and special funds have been given to the VL control program [ 25 ], VL transmission has been under effective control in China. Recently, however, cases of MT-ZVL have re-emerged in multiple endemic areas of China, with a gradual increase in cases each year [ 26 ]. The present study, therefore, aimed to retrospectively analyze the epidemiology, and identify the spatio-temporal distribution, of MT-ZVL in Gansu, Shaanxi, Sichuan, Shanxi, Henan and Hebei provinces between 2015 and 2019, in order to explore the spatio-temporal within the specified time period.…”

Section: Discussionmentioning

confidence: 99%

“…Joinpoint regression analysis determined a decline in VL incidence in China during the 2015 to 2019 study period, but an increase in MT-ZVL incidence ( t = 4.87, P < 0.05), most notably significant in Shanxi province ( t = 16.91, P < 0.05). These findings demonstrate that transmission of MT-ZVL is increasing, rather than declining, in some part of China, with an observable increase in MT-ZVL transmission during the past three years, and re-emergence of MT-ZVL in multiple transmission-controlled areas [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Reinforced control efforts have resulted in a substantial decline in number of VL cases in China during the 2015 to 2019 time period [ 26 ], however, transmission of MT-ZVL appears to be increasing, rather than declining. Although sporadic outbreaks of MT-ZLV appear in China, there has been a substantial increase in the MT-ZVL epidemics during the past three years [ 11 ], with an increase in high-incidence clusters in localised regions [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Among those hotspots, they have always been found in the southern Gansu province and northern Sichuan province, and PLOS NEGLECTED TROPICAL DISEASES multiple hotspots were detected in southern and southwestern parts of Shaanxi province, and in local regions of southwestern and eastern Shanxi province during later three years. Retrospective space-time scanning analysis identified 3, 2, 3, 3 and 6 clusters of MT-ZVL incidence in Gansu, Shaanxi, Sichuan, Shanxi, Henan and Hebei between 2015 and 2019, which https://doi.org/10.1371/journal.pntd.0009152.g010 Reinforced control efforts have resulted in a substantial decline in number of VL cases in China during the 2015 to 2019 time period [26], however, transmission of MT-ZVL appears to be increasing, rather than declining. Although sporadic outbreaks of MT-ZLV appear in…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

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Spatio-temporal clustering of Mountain-type Zoonotic Visceral Leishmaniasis in China between 2015 and 2019

Hao

Gong

et al. 2021

PLoS Negl Trop Dis

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With several decades of concerted control efforts, visceral leishmaniasis(VL) eradication had almost been achieved in China. However, VL cases continue to be detected in parts of western China recent years. Using data of reported cases, this study aimed to investigate the epidemiology and spatio⁃temporal distribution, of mountain-type zoonotic visceral leishmaniasis (MT-ZVL) in China between the years 2015 and 2019. Epidemiological data pertaining to patients with visceral leishmaniasis (VL) were collected in Gansu, Shaanxi, Sichuan, Shanxi, Henan and Hebei provinces between the years 2015 and 2019. Joinpoint regression analysis was performed to determine changes in the epidemic trend of MT-ZVL within the time period during which data was collected. Spatial autocorrelation of infection was examined using the Global Moran’s I statistic wand hotspot analysis was carried out using the Getis-Ord Gi* statistic. Spatio-temporal clustering analysis was conducted using the retrospective space-time permutation flexible spatial scanning statistics. A total of 529 cases of MT-ZVL were detected in the six provinces from which data were collected during the study time period, predominantly in Gansu (55.0%), Shanxi (21.7%), Shaanxi (12.5%) and Sichuan (8.9%) provinces. A decline in VL incidence in China was observed during the study period, whereas an increase in MT-ZVL incidence was observed in the six provinces from which data was obtained (t = 4.87, P < 0.05), with highest incidence in Shanxi province (t = 16.91, P < 0.05). Significant differences in the Moran’s I statistic were observed during study time period (P < 0.05), indicating spatial autocorrelation in the spatial distribution of MT-ZVL. Hotspot and spatial autocorrelation analysis revealed clustering of infection cases in the Shaanxi-Shanxi border areas and in east of Shanxi province, where transmission increased rapidly over the study duration, as well as in well know high transmission areas in the south of Gansu province and the north of the Sichuan province. It indicates resurgence of MT-ZVL transmission over the latter three years of the study. Spatial clustering of infection was observed in localized areas, as well as sporadic outbreaks of infection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

See 2 more Smart Citations

Spatio-temporal clustering of Mountain-type Zoonotic Visceral Leishmaniasis in China between 2015 and 2019

Hao

Gong

et al. 2021

PLoS Negl Trop Dis

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“…The infant fell ill in winter, and denied sandfly bites and family aggregation diseases. She lived in Handan City of Hebei Province, a non-VL epidemic area, and had spent a short time in Yangquan City of Shanxi Province, where sporadic leishmaniasis was found (Zhou, et al, 2020). It was difficult to make a biased judgment according to her symptoms, especially when routine pathogen culture, PCR and serological examination were all negative.…”

Section: Discussionmentioning

confidence: 99%

A case of pediatric visceral leishmaniasis-related hemophagocytic lymphohistiocytosis diagnosed by mNGS

Guo

Kang

2020

International Journal of Infectious Diseases

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Background: Visceral leishmaniasis-related hemophagocytic lymphohistiocytosis (VL-HLH) is a secondary hemophagocytic syndrome, which can be life-threatening, caused by leishmania and transmitted by infected sandflies. Rapid and accurate identification of leishmania is crucial for clinical strategies. Case report: Here, we report an infantile infection in a non-epidemic area of China. The infant was a 9.5month-old girl with fever, pancytopenia and hepatosplenomegaly, which meet the HLH-2004 standard, and the negative gene results exclude congenital HLH. However, chemotherapy is ineffective and is accompanied by severe infection. Fortunately, she is diagnosed with VL-HLH (visceral leishmaniasisrelated hemophagocytic lymphohistiocytosis), as leishmania is detected by next-generation metagenome sequencing (mNGS) and quickly relieved after treatment with libosomal amphotericin B (L-AMB). Conclusion: mNGS can detect leishmania in pediatric HLH, and should be performed as a new detection for VL-HLH, particularly for infants, who may not respond to HLH-2004 regimen.

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Epidemiological features and spatial–temporal distribution of visceral leishmaniasis in mainland China: a population-based surveillance study from 2004 to 2019

et al. 2021

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Background Although visceral leishmaniasis (VL) was largely brought under control in most regions of China during the previous century, VL cases have rebounded in western and central China in recent decades. The aim of this study was to investigate the epidemiological features and spatial–temporal distribution of VL in mainland China from 2004 to 2019. Methods Incidence and mortality data for VL during the period 2004–2019 were collected from the Public Health Sciences Data Center of China and annual national epidemic reports of VL, whose data source was the National Diseases Reporting Information System. Joinpoint regression analysis was performed to explore the trends of VL. Spatial autocorrelation and spatial–temporal clustering analysis were conducted to identify the distribution and risk areas of VL transmission. Results A total of 4877 VL cases were reported in mainland China during 2004–2019, with mean annual incidence of 0.0228/100,000. VL incidence showed a decreasing trend in general during our study period (annual percentage change [APC] = −4.2564, 95% confidence interval [CI]: −8.0856 to −0.2677). Among mainly endemic provinces, VL was initially heavily epidemic in Gansu, Sichuan, and especially Xinjiang, but subsequently decreased considerably. In contrast, Shaanxi and Shanxi witnessed significantly increasing trends, especially in 2017–2019. The first-level spatial–temporal aggregation area covered two endemic provinces in northwestern China, including Gansu and Xinjiang, with the gathering time from 2004 to 2011 (relative risk [RR] = 13.91, log-likelihood ratio [LLR] = 3308.87, P < 0.001). The secondary aggregation area was detected in Shanxi province of central China, with the gathering time of 2019 (RR = 1.61, LLR = 4.88, P = 0.041). The epidemic peak of October to November disappeared in 2018–2019, leaving only one peak in March to May. Conclusions Our findings suggest that VL is still an important endemic infectious disease in China. Epidemic trends in different provinces changed significantly and spatial–temporal aggregation areas shifted from northwestern to central China during our study period. Mitigation strategies, including large-scale screening, insecticide spraying, and health education encouraging behavioral change, in combination with other integrated approaches, are needed to decrease transmission risk in areas at risk, especially in Shanxi, Shaanxi, and Gansu provinces. Graphical abstract

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Visceral Leishmaniasis — China, 2015−2019

Cited by 16 publications

References 4 publications

Spatio-temporal clustering of Mountain-type Zoonotic Visceral Leishmaniasis in China between 2015 and 2019

Spatio-temporal clustering of Mountain-type Zoonotic Visceral Leishmaniasis in China between 2015 and 2019

A case of pediatric visceral leishmaniasis-related hemophagocytic lymphohistiocytosis diagnosed by mNGS

Epidemiological features and spatial–temporal distribution of visceral leishmaniasis in mainland China: a population-based surveillance study from 2004 to 2019

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