福建省消除疟疾地区重新流行风险指标体系的构建

Establishment of re-epidemic risk index system of the elimination of malaria in Fujian Province

目的在福建省连续十年没有当地感染疟疾的背景下,建立消除疟疾地区重新流行风险指标体系并确定各指标权重。方法遵循专家德尔菲法和层次分析法,选择恰当符合我省疟疾防控实际的指标建立评价指标体系,并确定各指标的权重。结果专家咨询的积极系数为100%,权威系数为0.842,Kendall协调系数为0.493,χ2=29.5740,P<0.001。构建福建省消除疟疾地区重新流行风险指标评估体系,包括5个一级指标,11个二级指标,指标体系的内在信度Cronbach’s alpha系数为0.7725>0.7,基本符合要求。结构效度分析,KMO值为0.527,Bartlett’s检验的χ2=80.807,P=0.013<0.05,适合作因子分析。评价指标的公因子方差均大于0.74,5个主成分的累积贡献率为85.743%。根据专家综合评分应用层次分析法确定各级指标权重,其中一级指标包括传染源、传疟媒介、易感人群、自然因素和社会因素,权重分别为0.263 8,0.510 0,0.129 6,0.032 9,0.063 6;λmax=5.237 2,CI=0.059 3,CR=0.052 9。各评价指标的组合权重中,媒介按蚊种类的权重最高,为0.340 2,各县输入型病例数权重第2,为0.230 8,符合我省目前疟疾消除的防控现状。结论选择恰当符合福建省实际的指标建立了消除疟疾地区重新流行指标体系,为今后科学、客观、全面的对疟疾重新流行的风险评价提供基础。

Under the background of the elimination of malaria basically in Fujian Province, we established the re-epidemic risk index system in the elimination of malaria areas, and aimed to obtain the weights of each index. The indexes which meet the reality of prevention in Fujian Province were filtered by the method of literature analysis and Delphi method. Analytical hierarchy process was used to calculate the weights at three levels. The positive coefficient of experts was 100 ~/00, the expert authority coefficient was 0. 842, and the Kendall coordination coefficient was 0. 493, X2 = 29. 574 0, P〈0. 001. The index system consis- ted of 5 firslee indexes and 11 second-~evel indexes. CronbacW s alpha coefficient of index system was 0. 772 5〉0.7, which meet the requirements basically. Through the construction validity analysis, KMO value was 0o 527, Bartlett＇s test 2 _ 80. 807, P= 0. 013%0.05,the variances of all evaluation indexs were more than 0.74, and the cumulative proportion of the 5 principal components was 85. 743%. According to the comprehensive score of experts and application of AHP to deter＇mine weights of all indexs, first-level indexes included the source of infection, malaria vector, the susceptible population, natural ~actors and social factors,their weights was 0. 263 8,0. 510 0,0. 129 6,0. 032 9 and 0. 063 6,λmax was 5. 237 2,the consistency index was 0. 059 3, random consistency ratio was 0. 0529. the weight of Anopheles species index is 0. 3402, which was the highest one and weight of imported cases is the second one and the value was, 0. 230 8, which is in line with the current situation at present malaria elimination in our province. The establishment of the re epidemic risk index system in the elimination of malaria areas will lay the foundation for the assessment of malaria risk scientifically, objectively and comprehensively.