Long-term trends in the epidemiology of human leptospirosis (Slovak Republic, 1954-2006)
Long-term trends in the epidemiology of human leptospirosis (Slovak Republic, 1954-2006)
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DOI：
10.1007/s10096-012-1551-8
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发表时间：
2012-09-01
影响因子：
4.5
通讯作者：
Jarekova, J.
中科院分区：
文献类型：
--
作者：
Bakoss, P.;Machacova, E.;Jarekova, J.
本研究的目的是观察斯洛伐克人类钩端螺旋体病在很长一段时间内的一些基本流行病学特征的最终变化。对人类钩端螺旋体病的流行病学特征进行了三个十年的评估：1954-1963年（822例）、1976-1985年（477例）和1997-2006年（310例）。评估内容包括病例的病因结构、发病率、患者的男女比例以及患者的职业和季节分布。受影响最大的特征是发病率，随着时间的推移，发病率下降了 70% 以上。另一个相当大的变化是钩端螺旋体病不同主要血清学类型的比例。最初盛行的 Sejroe 感染的百分比排名下降至第四位，而在观察开始时排名第二的 Grippotyphosa 疾病则成为主导。黄疸出血性疾病从第四位攀升至第二位。在整个研究期间，波莫纳+塔拉索维感染保留了第三名。与按年龄和性别划分的钩端螺旋体病比例相比，年龄和性别特异性发病率具有明显的趋势；随着时间的推移，这两个参数的值仅发生了微小的变化。患病者的男女比例（MWR）的总体值在所有三个时间段内实际上都在相同的范围内，但根据不同的年龄组而变化。相对于致病钩端螺旋体血清型的 MWR 随着时间的推移保持稳定，但不同血清型之间存在显着差异。与年龄和病因相关的发病率对于钩端螺旋体病的主要血清学类型表现出不同的趋势。钩端螺旋体病的职业分布发生了变化：农民和田间工人的病例比例显着下降，家庭主妇+养老金领取者的病例比例有所增加，但屠宰场工人/屠夫、小学生+学生和工人的病例比例略有变化。患者季节分布无明显变化；整个观察期间，7月至11月期间的病例比例最高。 50 年来，人类钩端螺旋体病的流行病学特征在斯洛伐克共和国经历了重要转变。它们与本文讨论的经济、社会和政治变化密切相关。研究结果可能对其他欧洲国家的专家有用。
The purpose of this study was the observation of eventual shifts in some basic epidemiological features of human leptospirosis in Slovakia over a long period of time. Epidemiological traits of human leptospirosis were evaluated in three decades: 1954-1963 (822 cases), 1976-1985 (477 cases) and 1997-2006 (310 cases). The evaluation encompassed the aetiologic structure of cases, the incidence rate of diseases, men-to-women ratio of patients, as well as the professional and seasonal distribution of patients. The most affected feature was the incidence rate, which decreased by more than 70% over time. Another considerable change was the proportion of different major serological types of leptospirosis. The initially prevailing Sejroe infections fell to 4th place in the percentage rank, while Grippotyphosa disease, which was ranked 2nd place at the beginning of the observations, became dominating. Icterohaemorrhagiae disease climbed from 4th place to 2nd place. Third place was reserved by the Pomona + Tarassovi infections during the whole study period. A distinct tendency of age- and gender-specific incidence rate compared to the proportion of leptospirosis by age and gender was noticed; only minor alterations of the values of both parameters were registered over time. The overall value of the men-to-women ratio (MWR) of diseased persons was virtually within the same range in all three time periods but varied according to different age groups. The MWRs relative to the causal Leptospira serovars were stable over time but markedly differed among distinct serovars. Incidence rates related to age and aetiology showed different trends for the major serological types of leptospirosis. Changes were observed in the professional distribution of leptospirosis: there was an important proportional decrease of cases among farmers and field workers, an increase among house-wives + pensioners, but only some slight changes in abattoir workers/butchers, pupils + students and workers. The seasonal distribution of patients did not show any remarkable changes; the maximum percentage of cases occurred during the period extending from July to November during the whole period of observation. The epidemiological features of human leptospirosis underwent important shifts in the Slovak Republic over a 50-year period of time. They were very closely related to economical, social and political changes, which are discussed in this paper. The results may be useful for specialists in other European countries.