2020-2021年河南省市级疟疾诊断实验室检测能力评估

Analysis of malaria detection capacity of Henan province in 2020-2021

目的 对市级疟疾诊断实验室送交的样本进行复核,评价市级疟疾检测能力。方法 对2020-2021年收到的疟疾血涂片和抗凝全血样本进行复核,依据血涂片制作、染色、清洁度等指标对血涂片进行逐张评分,评价和比较各送样单位血涂片质量,计算血片制作染色合格率。采用镜检和荧光PCR对样本进行复核,分析和比较送样单位疟疾阳性符合率和虫种符合率情况。结果 2020-2021年各市级疟疾诊断实验室送交的134份血涂片、137份抗凝全血样本(存在一例病例多家单位送样),河南省疟疾诊断参比实验室复核确认疟疾病例118份,其中间日疟原虫11份,恶性疟原虫48份,三日疟原虫9份,卵型疟原虫45份,混合感染5份,阴性19份。市级疟疾诊断实验室平均阳性符合率86.13%(118/137),虫种符合率83.89%(99/118)。134张血涂片制作、染色、清洁度及综合判定的合格率分别为98.50%(132/134),70.14%(94/134),69.40%(93/134)和97.01%(130/134)。市级疟疾诊断实验室血涂片镜检阳性符合率86.56%(116/134),虫种符合率84.48%(98/116),间日疟原虫,恶性疟原虫、卵形疟原虫、三日疟原虫、混合感染的误判率分别为18.18%(2/11),4.17%(2/48),22.22%(10/45),22.22%(2/9),80.00%(4/5)。结论 应持续提高血涂片染色质量,通过推进市级疟疾诊断实验室网络建设,提高疟疾检测准确率,巩固河南省消除疟疾成果。

Objective To re-examine the malaria blood smear and whole anticoagulant blood submitted by the city-level malaria laboratory in Henan province, and to evaluate the testing ability of malaria at the municipality level. Methods Malaria blood smears and anticoagulant whole blood samples from 2020 to 2021 were re-examined by Henan Provincial Malaria Diagnostic Reference Laboratory. The blood smears were scored one by one according to the smear production, staining, and cleanliness.The quality and the qualified rate of blood smears of each sending unit was evaluated and compared.The samples were checked by microscopy and fluorescent PCR, and the positive and species coincidence rates of malaria samples were analyzed. Results From 2020 to 2021, Henan Provincial Malaria Diagnostic Reference Laboratory received 134 blood smears and 137anticoagulant whole blood(including one case senting by multiple units) from the municipal Centers for Disease Control and Prevention.The Provincial reference laboratory confirmed 118 cases including 11 plasmodium vivax, 48 plasmodium falciparum,9 plasmodium malariae, 45 plasmodium ovale, 5 cases of mixed infection, and 19 negative cases.The average positive coincidence rate of municipal malaria diagnostic laboratory was 86.13%(118/137) and the species coincidence rate was 83.89%(99/118). The qualified rates of the 134 blood smears for making, staining, cleanliness and comprehensive judgment were98.50%(132/134), 70.14%(94/134), 69.40%(93/134) and 97.01%(130/134), respectively. The positive coincidence rate of blood smears in municipal malaria diagnostic laboratory was 85.56%(116/134), the species coincidence rate was 84.48%(98/116), the misjudgment rate of P.vivax, P.falciparum, P.ovale, P.malariae and mixed infection was 18.18%(2/11), 4.17%(2/48),22.22%(10/45), 22.22%(2/9), 80.00%(4/5), respectively. Conclusion The quality of blood smear staining should be continuously improved, and the accuracy of malaria detection should be improved by promoting the construction of the municipal malaria diagnostic laboratory network to consolidate the results of malaria elimination in Henan province.