安徽省县级血防机构血吸虫病诊断能力现状调查与分析

Surveillance and analysis on the diagnostic capabilities of schistosomiasis at countyleveled institutions,Anhui province

目的了解安徽省县级血防机构的血吸虫病诊断能力现况及存在问题,为进一步加强血吸虫病查病规范与质量控制提供科学依据。方法由安徽省国家级血吸虫病监测点随机抽取6个监测点作为调查对象。设计调查表调查监测点所在县区级血防机构的实验室条件、检验人员构成等基本情况;同时,通过监测点血清留样间接血凝试验(IHA)复查、加藤片抽样复核方式,调查县级机构血吸虫病免疫与病原学诊断技术水平。结果 6家县级血防机构基本配备了常规血吸虫病诊断所需仪器设备。实验室人员的平均年龄为34.3～43.8岁之间,检验专业比例平均为80%,专科及以上学历占48.4%,初级及以下职称构成比为73.3%(22/30)。血清IHA复检与原始检测的总符合率,2个监测点为100%,余4点为86.1%～95.4%,且阳性符合率低于阴性符合率。IHA原始检测为阳性血清复检,最高效价符合率为93.8%,其次为65 5%,余4监测点均低于20%。各监测点的阴性加藤片复检符合率为100%,阳性加藤片符合率为66.7%～100%。结论在进一步加强县级血防机构检验技术人员的技能培训的同时,加强对基层血吸虫病诊断过程的质量控制。

Objective To investigate the current status and problem in the diagnostic capabilities of schistosomiasis at county level in Anhui province, and to provide scientific information for improving the diagnosis quality of schistosomiasis. Methods Six villages were randomly sampled from nation-leveled schistosomiasis monitoring sites in Anhui province. The conditions and staff component of the station laboratories were investigated with specific questionnaire, and the abilities of immunological and parasitological diagnosis on schistosomiasis were tested by reexamining the retention samples of serum and Kato-Katz smears. Results Six schistosomiasis control stations were basically equipped with experimental devices for routine schistosomiasis diagno- sis. The average age of laboratory staff was 34.3～43.8 years old. The proportion of the stations with college degree or higher and with testing profession accounted for 48.4%, 80%, respectively. The staff with primary professional tides or below was 73.3%（22/30）. To compare the results of re-examination and original detection of sera, the coincidence rate was 100% in two monitoring sites, and from 86.1% to 95.4% in the other four sites, with the positive consistent rates being less than the negative ones. The highest coincidence rate of the agglutination titer was 93.8% testing for the originally positive sera, the second was 65.5%, and the other four sites were less than 20%. No schistosome eggs were found in the original egg-negative smears, and the coincidence for the egg-positive smears was from 66.7% to 100%. Conclusion The process quality control for population-based schistosomiasis diagnosis should be strengthened besides remaining diagnostic skill training for current laboratory personnel in county-leveled schistosomiasis institutions.