河北省助产机构实验室梅毒检测服务能力现状调查分析

Investigation and analysis of the current situation of laboratory testing of syphilis in midwifery institutions in Hebei Province

目的分析河北省助产机构实验室梅毒检测服务能力,为河北省消除梅毒母婴传播提供政策依据。方法采用调查问卷和实地调查相结合的方法,收集河北省各级助产机构实验室梅毒检测服务能力资料,包括实验室资质、检测方法、转诊和质控等。结果河北省助产机构中,96.36%(371/385)助产机构具有孕产妇梅毒血清学筛查能力,3.64%(14/385)助产机构没有梅毒血清学筛查资质中以乡级机构为主,占乡级助产机构的19.70%(13/66)。58.44%(225/385)的助产机构同时开展梅毒螺旋体血清学试验和非梅毒螺旋体血清学试验两种方法。37.92%(146/385)助产机构只开展一种血清学试验方法中96.56%(141/146)助产机构用梅毒螺旋体血清学试验方法进行筛查。助产机构梅毒螺旋体血清学试验中能开展化学发光免疫试验占比最高为61.48%(225/366),不同级别助产机构毒螺旋体血清学试验方法不同,县级以化学发光免疫试验和快速检测为主,占23.51%(63/268),乡级以单一RT方法为主,占42.42%(28/66)。22.64%(84/371)实验室未开展室间质控,14.32%(52/363)实验室未开展室内质控。私立助产机构未接受国家推荐规范操作培训比例为13.04%(9/69),高于公立机构。结论河北省助产机构实验室梅毒筛查检测网络覆盖比较全,极少数乡级助产机构没有梅毒筛查能力,但助产机构梅毒确诊检测服务能力不足,实验室质控工作待加强。建议加强助产机构实验室能力建设,提高梅毒确诊能力,加强实验室质控管理和规范培训,提高实验室服务质量。

Objective To analyze the capacity of laboratory testing of syphilis in midwifery institutions in Hebei Province,and to provide a policy basis for the elimination of mother-to-child transmission of syphilis in Hebei Province.Methods Questionnaire and field survey methods were used to collect the data about the capacity of laboratory testing of syphilis in all-level midwifery institutions in Hebei Province,including laboratory qualification,testing methods,referral and quality control.All data were analyzed by Excel.Results In Hebei Province,96.36%of midwifery institutions were able to perform serological screening of syphilis,and among 3.64%(14/385)of midwifery institutions without the capacity to perform serological screening of syphilis,most of them were township institutions,accounting for 19.70%(13/66)of the township midwifery institutions.Screening treponemal and non-treponemal assays were performed simultaneously in 55.84%(225/385)of midwifery institutions.37.92%(146/385)of midwifery institutions performed one assay,there were 96.36%(141/146)laboratories of these laboratories carried the detection of specific antibadies for treponema pallidum,in which CLIA(chemiluminescence immunoassay)was the most performed,accounting for 61.48%(225/366).Serological screening methods of syphilis at different levels varied.Among them,CLIA and RT(rapid detection test)were mainly used in the county-level institutions,accounting for 23.51%(63/268),and single RT was mainly used in the township-level institutions,accounting for 42.42%(28/66).22.64%(84/371)and 14.32%(52/363)of midwifery institutions for syphilis screening did not conduct external and internal quality control,respectively.The proportion of private midwifery institutions that did not receive national recommended standard operation training was 13.04%(9/69),which was higher than that of public institutions.Conclusion Midwifery institutions for syphilis screening in Hebei province cover a wide geographical range,and few township-level institutions lack the capacity to screen syphilis.However,the service capacity of midwifery institutions to screen syphilis is insufficient,with the laboratory quality control to be continuously improved.It is recommended to strengthen the construction of midwifery institutions for syphilis screening,enhance the testing ability,improve the laboratory quality control management and standardized training,and the quality of laboratory services.