《布鲁氏菌病诊断》(WS 269—2019)标准应用的调查评价  

Investigation and evaluation of Brucellosis Diagnosis(WS 269—2019)

作　　者：罗波艳 聂守民 王曦迎 范锁平[1] 安翠红[1] 王文静 周地佳 孙养信[1] LUO Bo-yan;NIE Shou-min;WANG Xi-ying;FAN Suo-ping;AN Cui-hong;WANG Wen-jing;ZHOU Di-jia;SUN Yang-xin(Shaanxi Provincial Center for Disease Control and Prevention,Xi′an 710054,China;School of Public Health,Xi’an Jiaotong University Health Science Center,Xi′an 710049,China)

机构地区：[1]陕西省疾病预防控制中心,西安710054 [2]西安交通大学医学部公共卫生学院,西安710049

出　　处：《中国人兽共患病学报》2023年第5期509-514,共6页Chinese Journal of Zoonoses

基　　金：2021年度公共卫生领域卫生健康标准评估项目。

摘　　要：目的了解《布鲁氏菌病诊断》(WS 269—2019)(简称标准)的宣贯、实施和使用情况以及使用过程中存在的问题,为标准的修订和完善提供参考。方法采用分层抽样调查和国家布病监测防控工作系统公开广泛调查相结合的方法,对全国布病一、二、三类部分流行地区的各级疾病预防控制中心(简称疾控机构)和临床医疗机构中从事布病流行病学调查、实验室检验和临床诊治的卫生专业人员开展问卷调查和访谈。结果参与问卷调查的省份(直辖市)有16个,共调查疾控机构和临床医疗机构763家,收回问卷1479份,问卷有效率为100.00%,其中调查疾控机构261家,完成问卷调查530份;调查临床医疗机构502家,完成问卷调查949份。调查对象平均年龄为(40.29±9.62)岁,学历中本科及以上占56.19%,职称以中初级职称占比最高(占34.75%),专业以临床诊断治疗为主(占48.88%),专业年限以5年以下为主(占54.02%)。1479名调查对象中,标准知晓率为88.30%(1306/1479),其中疾控机构知晓率为92.83%(492/530),临床医疗机构知晓率为85.77%(814/949),两者差异具有统计学意义(χ2=16.391,P<0.001);布病相关实验室检验项目开展率为79.86%(1043/1306),且调查对象所在的省市级医疗机构布病相关实验室检验项目开展率最高,为88.79%(285/321),其次为县区级(87.79%,460/524)和乡镇级(64.64%,298/461)医疗机构,差异有统计学意义(χ2=102.752,P<0.001)。1.35%(20/1479)认为该标准与国家法律法规及其他相关标准、现行教材矛盾。通过问卷调查和电话回访共收集到关于布病检验、病例诊断和宣贯培训3个方面的意见和建议。结论该标准是现阶段开展布病诊断工作的唯一指导性文件,建议进一步完善和修订该标准,加强该标准的宣贯和培训,提高临床医疗机构对该标准的使用和掌握,提升布病检测水平和特异性,从而有效推进布病防治工作的开展。In this study,questionnaires and interviews were conducted with health professionals engaged in epidemiological investigation,laboratory testing and clinical diagnosis and treatment of brucellosis in disease prevention and control centers(CDC)and clinical medical institutions at all levels in areas I,II and III affected by the national brucellosis epidemic.The study was conducted in the form of a questionnaire star.We performed a stratified sampling survey,and open and extensive investigation of the national brucellosis surveillance and control work system.A total of 16 provinces,763 medical units and 1479 health professionals participated in the questionnaire survey,including 261 CDC and 502 clinical medical institutions.Among the 1479 respondents,1306 answered that they knew the standard.The awareness rate was 88.30%,including 92.83%of CDC and 85.77%of clinical medical institutions;the difference was statistically significant.The main training mode was self-study(92.94%).The development rate of laboratory test items related to brucellosis was 79.86%.The standard had good applicability,advancement and operability,but was inconsistent with national laws and regulations,other relevant standards and current teaching materials.Opinions and suggestions regarding brucellosis testing,case diagnosis,and awareness and implementation training were collected through a questionnaire survey and telephone return visit.

关 键 词：布鲁氏菌病 诊断标准 跟踪评价 

分 类 号：R516.7[医药卫生—内科学]