2014年湖北省血吸虫病人群查病工作质量控制结果  

Analysis of quality control for schistosomiasis detection of Hubei Province( 2014)

作　　者：李博[1] 朱红[1] 何汇[1] 唐丽[1] 李小萍[1] 利国[1] 涂祖武[1] 蔡顺祥[1] 

机构地区：[1]湖北省疾病预防控制中心,武汉430079

出　　处：《公共卫生与预防医学》2016年第5期44-47,共4页Journal of Public Health and Preventive Medicine

基　　金：湖北省卫生计生血防专项(WJ2015XA001);湖北省卫生计生血防专项(WJ2015XB010);湖北省科技支撑计划项目(2015BCA315)

摘　　要：目的为提高湖北省基层血防专业技术人员血吸虫病检测检验能力,保证血吸虫病查病工作质量。方法对湖北省21个疫区县（市、区）全年血清学、病原学检测质量进行考核。结果抽查21个流行村,共复核血清样本9 342份,总符合率98.58%,总误检率为0.94%,总漏检率为8.87%,本地检测结果与复核结果差异有统计学意义（χ^2=7.226,P〈0.01）。抽查13个流行村296份阳性血清,样本滴度≥1：80的占检测总数的17.50%,垸内型、垸外洲滩型和丘陵型3类地区阳性血清样本滴度分布均无统计学意义（χ^2=19.79,P=0.071）。抽查了15个监测点的Kato-Katz片,共复核316张,其中阳性片23张,阴性片293张,总符合率100.00%;结论血清学、Kato-Katz片总体符合率较高;漏检率较高的原因有血清样本保存不规范和检测人员对弱阳判断存在误差;各地区需要对IHA高滴度人群进行监测与管理,要继续加强专业人才队伍建设。Objective To improve the ability of the diagnosis of schistosomiasis japonica for the grassroots technical personnel,and ensure the quality of diagnosis of schistosomiasis japonica. Methods Serological detection and pathogenic diagnosis were assessed in21 schistosomiasis endemic areas of Hubei Province in this year. Results 21 endemic villages were assessed,totally 9 342 serum samples were checked,the results showed that the rate of serological coincidence,misdiagnosis and missed diagnosis were 98. 58%,0. 94%,8. 87% respectively,and there was a significant difference between the local detection results and the reviewing results（ χ^2=7. 226,P〈0. 01. 296 positive serum samples in 13 endemic villages were assessed,the antibody titers were higher than（ or equal to）1： 80,accounting for 17. 50% in the total detected samples. No significant difference of the serological titer between the inner embankment,marshland and hilly areas was found（ χ^2= 19. 79,P = 0. 071）. 316 Kato-Katz thick smears of 15 surveillance sites were randomly inspected（ 23 positives,293 negatives）,with a total coincidence rate of 100. 00%. Conclusions The overall coincidence rate of serological detection and Kato-Katz was high. The high rates of missed diagnosis were caused by the improper preservation of serum samples and the misdiagnosis for the weak positive results. Monitoring and management for the IHA-high-titer population should be strengthened,and training for technical personnel should be promoted as well.

关 键 词：血吸虫病 血清学检测 Kato-Katz片 质量控制 

分 类 号：R532.21[医药卫生—内科学]