摘要目的:掌握甘肃省布鲁氏菌病（布病）高发地区人间布病的流行特征，为高发地区布病的精准化防控提供指导。方法:采用回顾性研究方法，自中央转移支付项目监测数据库收集2018 - 2020年甘肃省环县（东部）、瓜州县（西部）、张家川县（南部）、高台县（北部）和景泰县（中部）5个布病高发县的人间布病监测资料，描述性分析高发地区布病流行特征。结果:2018 - 2020年甘肃省布病高发地区实验室确诊布病病例共787例，患病率为3.64%；各年患病率依次为2.63%（205/7 780）、4.60%（327/7 111）、3.78%（255/6 746），不同年份间比较差异有统计学意义（χ 2 = 41.44， P < 0.001）。环县、瓜州县、张家川县、高台县和景泰县的布病患病率分别为0.02%（1/4 263）、3.67%（140/3 817）、4.32%（182/4 209）、4.89%（237/4 847）和5.04%（227/4 501），不同地区间比较差异有统计学意义（χ 2 = 211.59， P < 0.001）；2018年以中部的景泰县患病率最高，2019、2020年逐渐向南部的张家川县和北部的高台县分散。不同性别、年龄、民族、文化程度及职业人群患病率比较，差异均有统计学意义（χ 2 = 111.95、212.76、35.32、89.59、97.93，均 P < 0.001）。2018 - 2020年，< 20（0.78%、6.36%、10.00%），40 ~ < 50岁年龄组（5.15%、7.03%、8.00%），学生及幼儿（0.58%、9.20%、13.64%），干部（2.86%、4.55%、10.53%）布病患病率呈逐年升高趋势（χ 2趋势 = 21.55、7.00、30.63、2.01，均 P < 0.001）。 结论:甘肃省布病目前仍处于较高水平的增长阶段，疫区逐渐分散；且病例逐渐年轻化，重点职业人员由农牧民向社会工作人员转变。建议增加监测范围，加大宣传力度，提高重点人群的自我防控意识。

abstractsObjective:To study the epidemiological characteristics of human brucellosis in high incidence areas of brucellosis in Gansu Province, and provide a guidance for precise prevention and control of brucellosis in the areas with high incidence of the disease.Methods:Using a retrospective research method, human brucellosis monitoring data from five high incidence counties of brucellosis in Gansu Province from 2018 to 2020, including Huan County (eastern), Guazhou County (western), Zhangjiachuan County (southern), Gaotai County (northern), and Jingtai County (central), were collected from monitoring database of the Central Transfer Payment Project. The epidemic characteristics of brucellosis in high incidence areas were described and analyzed.Results:From 2018 to 2020, there were a total of 787 laboratory confirmed cases of brucellosis in high incidence areas of brucellosis in Gansu Province, with a prevalence rate of 3.64%. The incidence rates for each year were 2.63% (205/7 780), 4.60% (327/7 111), and 3.78% (255/6 746), with statistically significant differences between different years (χ 2 = 41.44, P < 0.001). The prevalence rates of brucellosis in Huan County, Guazhou County, Zhangjiachuan County, Gaotai County, and Jingtai County were 0.02% (1/4 263), 3.67% (140/3 817), 4.32% (182/4 209), 4.89% (237/4 847), and 5.04% (227/4 501), respectively. There was a statistically significant difference in comparison between different regions (χ 2 = 211.59, P < 0.001). In 2018, the incidence rate was highest in Jingtai County in the central region, and scattered to Zhangjiachuan County in the south and Gaotai County in the north in 2019 and 2020. There were statistically significant differences in the prevalence rates among different genders, ages, ethnicities, educational levels, and occupational groups (χ 2 = 111.95, 212.76, 35.32, 89.59, 97.93, P < 0.001). From 2018 to 2020, the incidence of brucellosis in the < 20 (0.78%, 6.36%, 10.00%), 40 - 50 age groups (5.15%, 7.03%, 8.00%), students and young children (0.58%, 9.20%, 13.64%), and cadres (2.86%, 4.55%, 10.53%) showed an increasing trend year by year (χ 2trend = 21.55, 7.00, 30.63, 2.01, P < 0.001). Conclusions:The brucellosis in Gansu Province is still in a high level of growth stage, and the epidemic area is gradually dispersing; the cases are gradually becoming younger, and key occupational personnel are shifting from farmers and herdsmen to social workers. It is recommended to increase the scope of monitoring, increase publicity efforts, and enhance the self-protection and control awareness of key populations.