疟疾消除后郴州市疟原虫血片质量分析  

Quality of blood smear examinations for malaria parasites in Chenzhou City after malaria elimination

作　　者：朱韩武[1] 侯僖硕[1] 阳慧[1] ZHU Hanwu;HOU Xishuo;YANG Hui(Chenzhou Center for Disease Control and Prevention,Chenzhou,Hunan 423000,China)

机构地区：[1]湖南省郴州市疾病预防控制中心,湖南郴州423000

出　　处：《中国血吸虫病防治杂志》2023年第5期497-500,共4页Chinese Journal of Schistosomiasis Control

基　　金：湖南省卫生健康委员会卫生科研课题(D202312079576)。

摘　　要：目的分析郴州市消除疟疾后疟原虫血片质量,为持续巩固消除疟疾成果提供科学依据。方法2018—2022年,不定期抽取郴州市各县(市、区)发热病人疟原虫血片,阳性血片全部进行复核、阴性血片抽检数量不少于总数的3%。对血片制作、染色、清洁度及镜检结果进行复核,采用描述性统计方法对血片质量复核结果进行分析。结果2018—2022年,郴州市累计开展发热患者疟原虫血检13625人,其中检出疟原虫阳性21人、阴性13604人。共复核血片687张,阳性血片21张、阴性血片666张,阴性血片复核率4.90%(666/13604),阴性血片制作合格率为63.51%、染色合格率为67.87%、清洁度合格率为76.13%,未发现漏检;复核所有阳性血片21张,制作合格率、染色合格率和清洁度合格率均为85.71%,发现分型错误血片2张(9.52%)。2022年阴性血片制作合格率为51.41%,较2019年显著下降(χ^(2)=9.033,P<0.05);2022年阴性血片染色合格率为60.19%,较2019年显著下降(χ^(2)=19.498,P<0.001);2022年阴性血片清洁度合格率为62.96%,较2019年显著下降(χ^(2)=23.826,P<0.001)。2020—2022年阴性血片制作合格率(χ^(2)=0.260,P>0.05)、染色合格率(χ^(2)=1.094,P>0.05)差异均无统计学意义,但清洁度合格率差异有统计学意义(χ^(2)=12.175,P<0.05)。结论疟疾消除后,郴州市发热患者疟原虫血检未出现漏检现象,血片制作、染色和清洁度合格率有所下降,应加强重点地区血片质量控制。Objective To analyze the quality of blood smear examinations for malaria parasites in Chenzhou City,so as to provide insights into sustainable consolidation of malaria elimination achievements.Methods All positive blood smears from fever patients were irregularly sampled from each county(district)of Chenzhou City from 2018 to 2022 and reexamined,and no less than 3%negative blood smears were reexamined.The preparation,dyeing,cleanliness and microscopic examination results of blood smear were reexamined,and the quality of blood smear reexaminations was assessed using a descriptive statistical method.Results A total of 13625 fever patients received blood smear examinations for malaria parasites in Chenzhou City from 2018 to 2022,of which 21 were positive and 13604 were negative;687 blood samples were reviewed,and the percentage of negative blood smear reexaminations was 4.90%(666/13604),with a 63.51%rate of qualified negative blood smears preparation,a 67.87%rate of qualified dyeing and a 76.13%rate of qualified cleanliness,and no missing diagnosis found.There were 21 positive blood smears reexamined,and the proportions of qualified blood smears preparation,dyeing and cleanliness were all 85.71%,with 2 smears mistaking Plasmodium species(9.52%).The percentage of qualified negative blood smears preparation was 51.41%in 2022,which reduced by 31.61%in relative to that(75.17%)in 2019([χ^(2)]=9.033,P<0.05),and the percentage of qualified negative blood smears dyeing was 60.19%in 2022,which reduced by 28.82%in relative to that(84.56%)in 2019([χ^(2)]=19.498,P<0.05),while the percentage of qualified negative blood smears cleanliness was 62.96%in 2022,which reduced by 28.93 in relative to that(88.59%)in 2019([χ^(2)]=23.826,P<0.05).In addition,there were no significant differences in the proportion of qualified negative blood smears preparation([χ^(2)]=0.260,P>0.05)or dyeing([χ^(2)]=1.094,P>0.05)among the three years,while a significant difference was detected in the percentage of qualified negative blood smears cleanlin

关 键 词：疟疾 疟原虫 消除 血检 质量评价 郴州市 

分 类 号：R531.3[医药卫生—内科学]