河北省部分医疗机构丙肝实验室检测能力和病例报告情况调查

Investigation on the laboratory testing ability and case reporting of hepatitis C in some medical institutions in Hebei Province

目的了解河北省部分医疗机构丙肝实验室检测能力及病例报告存在的问题,提高数据质量。方法对河北省内部分医疗机构丙肝实验室检测能力进行调查,收集该机构2020年第二季度的丙肝病例资料,与现行报告标准进行核对,评价丙肝病例报告情况。结果共调查158家医院,具备丙肝抗体检测能力的医院占100.0%,具备丙肝核酸检测能力的医院占22.2%,委托外单位开展核酸检测的医院占63.3%,三级医院与二级医院的核酸检测能力差异有统计学意义(P<0.001)。急性病例正确率为30.0%,小于1.5岁儿童病例正确率为0.0%,确诊病例正确率为62.5%,不同级别医院确诊病例报告正确率差异均有统计学意义(P<0.001);具备核酸检测能力医疗机构上报的正确率最高,与外送进行检测及不具备核酸检测能力的医疗机构差异有统计学意义(P<0.001);医疗机构HCV-RNA阳性病例网络上报率均为100.0%,正确率为95.8%,三级医院与二级医院正确率差异有统计学意义(P=0.001);78.6%的HCV-RNA阳性病例及时网报,具备核酸检测能力的医院及时率高于需要外送标本的医院,差异有统计学意义(P<0.001),外送标本的医院中二级医院及时性高于三级医院,差异有统计学意义(P=0.001);不同地区确诊病例报告正确率差异有统计学意义(P<0.001)。结论河北省丙肝核酸检测能力较弱,基层人员病例报告正确率较低,应进一步加强丙肝核酸实验室能力建设和基层医护人员培训,建立丙肝病例报告质量定期核查机制,提高丙肝诊断及病例报告质量。

Objective To understand the laboratory testing capabilities and cases report of hepatitis C in some medical institutions in Hebei Province,and to improve data quality.Methods A survey on the laboratory testing capacity of hepatitis C cases in some medical institutions in Hebei Province was conducted,the data on hepatitis C cases in the second quarter of 2020 was collected and compared with current reporting standards to evaluate the reporting status of hepatitis C cases.Results A total of 158 hospitals were surveyed.The hospitals with the ability to detect hepatitis C antibody accounted for 100.0%,hospitals with the ability to detect hepatitis C nucleic acid accounted for 22.2%,and hospitals that entrusted external units to carry out nucleic acid testing accounted for 63.3%.There was a statistically significant difference in nucleic acid testing ability between tertiary and secondary hospitals(P<0.001).The correct rate of acute cases was 30.0%,the correct rate of children cases younger than 1.5 years old was 0.0%,and the correct rate of confirmed cases was 62.5%.The difference in the correct rate of confirmed cases in different hospitals was statistically significant(P<0.001).The medical institutions with nucleic acid testing capabilities reported the highest accuracy rate,and there was a statistically significant difference(P<0.001)compared to medical institutions that were sent for testing or did not have nucleic acid testing capabilities.The network reporting rate of HCV-RNA positive cases in medical institutions was 100.0%,with a accuracy rate of 95.8%.There was a statistically significant difference in accuracy between tertiary and secondary hospitals(P=0.001).78.6%of HCV-RNA positive cases were reported online in a timely manner,and hospitals with nucleic acid testing capabilities had a higher timely rate than hospitals that needed to send out samples,with a statistically significant difference(P<0.001).Among hospitals that sent out specimens,the timeliness of second level hospitals was higher than that of third level hospitals,with a statistically significant difference(P=0.001).There was statistically significant difference in the accuracy rate of confirmed case reports among different regions(P<0.001).Conclusion The ability to detect hepatitis C nucleic acid in Hebei Province was weak,and the accuracy rate of case report among grassroots personnel was relatively low.It is necessary to further strengthen the capacity building of hepatitis C nucleic acid laboratories and the training for grassroots medical staff,establish a regular verification mechanism for the quality of hepatitis C case report,and improve the quality of hepatitis C diagnosis and case report.