内蒙古医疗机构后天梅毒报告病例准确性及其影响因素调查  

Accuracy of acquired syphilis cases reported by medical institutions and influencing factors in Inner Mongolia

作　　者：刘静 杨景元 龚向东[2] 裴迎新[3] 焦月英 LIU Jing;YANG Jingyuan;GONG Xiangdong;PEI Yingxin;JIAO Yueying(Inner Mongolia Center for Integrated Disease Control and Prevention,Inner Mongolia Hohhot 010031 ,China;National Center for STD Control,China CDC,Nanjing 210042;Chinese Center for Disease Control and Prevention,Beijing1O0050;Inner Mongolia People's Hospital,Hohhot 010031)

机构地区：[1]内蒙古自治区综合疾病预防控制中心,呼和浩特010031 [2]中国疾病预防控制中心性病控制中心,南京210042 [3]中国疾病预防控制中心,北京100050 [4]内蒙古自治区人民医院,呼和浩特010031

出　　处：《中国艾滋病性病》2018年第10期1032-1035,1046,共5页Chinese Journal of Aids & STD

基　　金：中国疾病预防控制中心西部现场流行病学项目(2017-W-08-18)~~

摘　　要：目的评估内蒙古地区医疗机构梅毒病例报告的准确性,了解梅毒病例报告准确性的影响因素。方法选取6个旗县区的30家医疗机构报告的后天梅毒报告病例进行调查,同时对选取医疗机构的474名医务人员的梅毒诊断和报告知识知晓情况进行调查,计算其合格率。采用单因素和多因素Logistic回归分析病例报告准确性的影响因素。结果共调查30家医疗机构报告的后天梅毒病例895例,报告准确率为62.46%(559例),实验室确诊病例准确率为69.88%(594/850),疑似病例准确率为11.11%(5/45)。一期、二期、三期和隐性梅毒报告准确率分别为45.18%(75/166)、50.75%(68/134)、100.00%(4/4)、76.48%(452/591)。临床医生梅毒诊断与报告知识合格率为77.64%(368/474)。多因素分析表明,医院级别高、皮肤科、性病监测点地区、临床医生近3年参加性病培训等,与梅毒报告准确率提高存在关联。结论调查地区梅毒病例报告准确率较低,梅毒疫情报告质量有待提高。建议加强监测培训工作,重点做好基层、非监测点和皮肤科以外相关科室医务人员的能力培训。Objective To evaluate accuracy of syphilis cases reported in Inner Mongolia and understand the influencing factors related to accuracy of reported syphilis cases.Methods Acquired syphilis cases in 30 medical institutions of 6 counties were selected in the survey.Clinical and laboratory data were collected to evaluate the accuracy of diagnosis,classification,stage division and other indicators.474 healthcare workers were selected to receive the survey of syphilis knowledge and awareness of reporting knowledge to calculate the pass rate.Univariate and multivariate logistic regression analysis was used to analyze the influencing factors related to the accuracy of reported cases.Results The accuracy rate of acquired syphilis cases reported was 66.93%(559/895);that of laboratory confirmed cases was 69.88%(594/850);and of suspected cases was 11.11%(5/45).The accuracy rates of primary,secondary,tertiary and latent syphilis were 45.18%(75/166),50.75%(68/134),100.00%(4/4)and 76.48%(452/591)respectively.The qualified rate of syphilis diagnosis and reporting by clinicians was 77.64%(368/474).Multivariate logistic regression analysis showed that the factors of high level of hospitals,dermatology department,sexually transmitted disease surveillance and clinical doctors who had participated in STD training in recent 3 years were associated with the improvement of the accuracy of syphilis reports.Conclusion Accuracy of syphilis reports is low in the areas under survey and quality of syphilis reports needs to improve.It is suggested to strengthen the surveillance and training,with the priority of capacity building for the doctors at the grassroots level,and working in non-surveillance areas and non-dermatology department.

关 键 词：后天梅毒 网络报告 准确性 影响因素 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]