新疆荒漠型黑热病流行病学调查及病原体利什曼原虫的基因分型研究

Kala-azar, commonly known as visceral leishmaniasis, is seriously harmful to human health as a parasitic zoonotic disease．Xinjiang is Kala-azar severe epidemic area. Kala-azar in Xinjiang can be classified into three types of diseases which are plain，desert and hill type．In Xinjiang, new cases constantly appeared in recent years and local outbreak sometimes occured. Good effect on prevention and control has been aquired by kill sandfly, general survey patients and treatment of patients in plain and hill Kala-azar. But effective prevention and control measures of desert Kala-azar in Xinjiang is still scarce. A comprehensive system investigation is lack about the overall characteristics of desert Kala-azar in Xinjiang. The study about situation in southern margin of the tarim basin cat not be found. This study intends to take out epidemiological investigation about desert Kala-azar in Minfeng prefecture of Hotan region (the south edge of tarim basin) and Jiashi prefecture of Kashgar region (the north edge of tarim basin), for mastering epidemiological characteristics of desert Kala-azar in Xinjiang. The research of genotyping classification of Leishmania acquired from patients, sandflies and wild animals will also be carried out. Through this study, comprehensively grasp the epidemiological characteristics of desert Kala-azar in Xinjiang and genetic characteristics of the strains of Leishmania should be accomplished. A practical and effective prevention and control strategies will be developed. At the same time this study also could provide scientific basis for the research of distribution characteristics of Kala-azar in Xinjiang and predicting potential epidemic area.

黑热病又称内脏利什曼病，是一种严重危害人类健康的人兽共患寄生虫病。新疆是黑热病高发区，主要存在三种类型：平原型、荒漠型和砾漠型。新疆近年病例报告显示新发疫点不断出现且局部暴发时有发生。平原型和砾漠型黑热病主要采取药物灭蛉结合普查病人和集中治疗患者的防治措施，已取得较好的防控效果。但是荒漠型黑热病目前仍缺乏有效防控措施。对于新疆荒漠型黑热病的总体流行特征缺乏全面系统的调查研究，如塔里木盆地南缘地区仍是新疆黑热病研究的空白区。为摸清新疆荒漠型黑热病流行特征，制定有效的防控策略，本研究拟选取塔里木盆地南缘的和田地区民丰县和北缘的喀什地区伽师县进行流行病学调查，并对由病人、白蛉和野生动物体内分离获得的虫株进行基因分型研究。通过本研究，预期能够较全面掌握新疆荒漠型黑热病流行病学特征及致病虫株的基因学特点，制定出切实有效的防控策略，亦为研究新疆黑热病疫区分布特征和预测潜在疫区发展趋势提供科学依据。

本项目的研究内容主要有（1）在新疆和田地区民丰县和喀什地区伽师县开展黑热病流行病学的调查；（2）动物感染实验；（3）对分离得到的利什曼原虫虫株进行分子生物学鉴定，以确定其遗传性特点和系统发生及其与西缘和北缘地区致病虫株的同源性；（4）根据上述研究结果制定新疆荒漠型黑热病预防控制策略。根据项目执行情况（1）伽师县和民丰县什曼原虫抗体检测阳性率分别为9.16%和4.44%；（2）伽师县媒介白蛉利什曼原虫感染率为1.83%，民丰县为0；（3）伽师县和民丰县主要家畜刀郎羊和主要啮齿类动物大沙鼠利什曼原虫感染率均为0，说明其不是当地利什曼原虫主要的保虫宿主之一；（4）从媒介白蛉体内分离获得的1株利什曼原虫虫株，其基因特性研究正在进行数据统计分析中；（5）制定了新疆荒漠型黑热病综合防控策略。