2012年全国寄生虫病防治技术竞赛成绩分析报告:Ⅰ.疟原虫检测能力考评结果分析

Analysis Report of the National Technique Competition for Diagnosis of Parasitic Diseases in 2012:Ⅰ.Capability Analysis of Plasmodium Detection

目的对2012年全国寄生虫病防治技术竞赛疟原虫检测能力考评成绩进行分析,了解防治专业人员的疟原虫检测能力。方法2012年5月,以省(市、区)为单位,每省选送各级疾控机构的在职专业技术人员4名(年龄≤45周岁,县级不少于2名)参赛。竞赛内容包括疟原虫厚、薄血片制作(每参赛选手30 min内制作完成3张血片,并做吉氏染色;计满分为10分,6分为及格)和疟原虫虫种鉴别、计数(每选手镜检5张血片,每张8 min,其中定性5分,定量1分,共计6分;计满分为30分,18分为及格)。用SPSS 11.6软件分别从参赛选手的性别、年龄、职称、单位级别、所在省份疟疾流行程度、经济发展状况和地理方位等方面对参赛选手疟原虫检测成绩进行统计学分析。结果本次竞赛共来自全国30个省(市、区)120名选手参加。血片制作平均成绩为8.7分,最高者为10分、最低者为5.8分,及格人数为118人,占98.3%;疟原虫镜检平均成绩为16.0分,最高者为29分,最低者为0分,及格人数为52人,占43.3%。疟原虫平均检出符合率为65.4%,17人(14.2%)达到100%,39人(32.5%)低于60%。间日疟和恶性疟的检出符合率分别为62.6%和67.8%,阴性标本的符合率为40.0%。不同性别、年龄、职称、单位级别参赛选手之间的成绩差异均无统计学意义(P>0.05);不同疟疾流行程度、地理方位和经济发展水平省份间选手成绩间差异均有统计学意义(P<0.05)。其中血片制片和镜检读片成绩,疟疾流行一类(9.29±0.41和18.17±6.42)、二类(8.92±0.79和18.31±6.94)和三类省(8.61±0.89和15.63±7.52)的参赛选手均高于非疟疾流行省份(7.95±1.00和10.19±7.01)(P<0.01);南方省份参赛选手(9.16±0.61和18.82±6.78)均显著高于北方省份(8.30±0.99和13.23±7.45)(P<0.01)。东部省份参赛选手的镜检读片成绩(18.20±6.88)显著优于西部省份(13.39±7.60)(P<0.05),两者血片制片成绩差异无统计学意义(P>0.05)。结论各省疟原虫检测能力总体水平尚不均衡。

Objective To analyze the result of the national technique competition for diagnosis of parasitic diseases in 2012, so as to understand the capability of detection on Plasmodium parasites among professionals from institutes for disease control and prevention at different levels. Methods Four professionals from institution were selected as contestants （age≤45 and at least two contestants from county-level institution）. The content of the competition included making thick and thin blood slides of Plasmodium（3 slides in 30 min, 10 scores as full marks and 6 as passing score） and identification of species and number with microscopy（5 slides, 8 min per slide, 30 scores as full marks and 18 as passing score）. All contestants were grouped by gender, age, professional title, level of institution, classification according to malaria endemicity, geographical location and economic developement of the province. Their scores were statistically analyzed by SPSS 16.0 software. Results The average score of blood smear making test in 120 contestants from 30 provinces was 8.7, the highest was 10 and the lowest was 5.8, 118（98.3%） contestants passed the test. The average score of blood smear reading was 16.0, the highest was 29 and the lowest was 0, 52（43.3%） contestants passed the test. There were no significant differences for the scores among genders, ages（≤30, 31-40, 〉40）, professional titles （junior, intermediate and senior）, institution levels （provincial, municipal or county level）（P〉0.05）. However, there was a significant difference among provinces with different malaria endemicity, geographical location and development status （P〈0.05）. For the blood slide-making and film-reading, scores of contestants from malaria endemic provinces including Class Ⅰ（9.29±0.41,18.17±6.42）, Class Ⅱ （8.92±0.79, 18.31±6.94） and Class Ⅲ （8.61±0.89, 15.63±7.52） were higher than those from non-endemic provinces （7.95±1.00, 10.19±7.01）（P〈0.01）. Scores of contestants from southern provinces（9.16±0.61, 18.82±6.78） were significantly higher than that from northern ones（8.30±0.99, 13.23±7.45）（P〈0.01）. The film-reading scores were significantly higher in those from eastern provinces（18.20±6.88） than those from western（13.39±7.60） （P〈0.05）, while no significant difference was found in blood slide-making （P〉0.05）. Conclusion The capability of malaria parasite detection is imbalanced.