疾控机构现场流行病学调查技术薄弱环节分析

Weakness in field epidemiological investigation proficiency among staff from centers for disease control and prevention

目的分析黑龙江省疾病预防控制机构应急人员在现场流行病学调查技术中存在的薄弱环节并提出改善其效率和质量相关建议。方法以黑龙江省各级疾病预防控制中心(CDC)共1 024名应急人员为研究对象,运用现场定量调查方法收集资料,TOPSIS综合评价方法筛选现场流调技术的薄弱环节。结果市级CDC人员技术薄弱环节主要为:"判断评估疫情"(C=0.922 436)、"确定检验项目及实验室检验"(C=0.890 746)及"病例搜索,依据搜索到的病例进行流行病学分析"(C=0.778 791)等;县区级CDC人员技术薄弱环节主要为"卫生学调查、个案调查"(C=0.989 718)、"样本采集、保存与运送"(C=0.925 922)和"病例核实"(C=0.922 206)等。结论黑龙江省市、县区级CDC人员的现场流调技术薄弱环节存在结构性差异,知识结构、综合素质差异及技术规范、培训演练状况差距等均是导致市、县区级CDC人员对现场流调技术薄弱环节评价结果不同的重要原因。

Objective To analyze weakness in field epidemiological survey proficiency among staff from centers for disease control and prevention（CDCs） in Heilongjiang province for the promotion of efficiency and quality of the field epidemiological survey. Methods A total of 1 024 professional and technical personnel in CDCs at various levels of Heilongjiang province were recruited for the study. Basic information were collected with a questionnaire. Technique for order preference by similarity to ideal solution（TOPSIS） was used for assess the weakness in field epidemiological inves- tigation. Results The main weaknesses for the staff from CDCs at city level were judgment and assessment of an epi- demic （ C = 0. 922436 ）, selection of test items and laboratory tests （ C = 0. 890746）, and case finding and epidemiological analysis （ C =0. 778791 ） ;the main weaknesses for the staff from CDCs at county or district level were case investigation for public health event（ C = 0. 989718 ）, sample preservation and transportation（ C = 0. 925922）, and verification of cases （ C = 0. 922206）. Conclusion There are differences in the weaknesses for field epidemiology investigation between the staff from CDCs at city and county level and the differences maybe result from knowledge structure and the gaps in com- prehensive proficiency, and professional training.