消除后阶段我国县区输入性疟疾防止再传播技术指标框架研究  

Construction of a technical indicator framework for the prevention of re-establishment of imported malaria in China during the malaria post-elimination stage

作　　者：刘博文 张滔[3] 刘婧姝[1,2] 霍诗怡 薛靖波 王多全 夏志贵 李卫东 李石柱[1,2,4] LIU Bowen;ZHANG Tao;LIU Jingshu;HUO Shiyi;XUE Jingbo;WANG Duoquan;XIA Zhigui;LI Weidong;LI Shizhu(School of Global Health,Chinese Center for Tropical Diseases Research and Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;One Health Center,Shanghai Jiao Tong University and The University of Edinburgh,Shanghai 200025,China;Anhui Provincial Center for Disease Control and Prevention,Hefei,Anhui 230061,China;National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases,National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention,Chinese Center for Tropical Diseases Research,NHC Key Laboratory of Parasite and Vector Biology,WHO Collaborating Center for Tropical Diseases,National Center for International Research on Tropical Diseases,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院-国家热带病研究中心全球健康学院,上海200025 [2]上海交通大学-爱丁堡大学全健康研究中心,上海200025 [3]安徽省疾病预防控制中心,安徽合肥230061 [4]传染病溯源预警与智能决策全国重点实验室,中国疾病预防控制中心寄生虫病预防控制所(国家热带病研究中心),国家卫生健康委员会寄生虫病原与媒介生物学重点实验室,世界卫生组织热带病合作中心,国家级热带病国际联合研究中心,上海200025

出　　处：《中国热带医学》2025年第1期1-8,共8页China Tropical Medicine

基　　金：国家自然科学基金项目(No.32161143036);一带一路澜湄热带病防控联合实验室项目(No.21410750200);上海市加强公共卫生体系建设三年行动计划(2023—2025年)重点学科项目;科技基础资源调查专项(No.2022FY100904)。

摘　　要：目的以我国除边境地区外的县区为目标,构建防止疟疾输入再传播技术指标框架,以指导专业机构进行科学、可行、综合的输入性疟疾防止再传播工作。方法利用文献分析法结合现场实际情况初步构建输入性疟疾防止再传播技术指标框架。研究共开展2轮德尔菲专家咨询法,计算专家积极系数、专家权威程度、专家意见协调程度和集中程度,综合评分结果及专家意见确定框架的最终指标,并利用层次分析法确定各级指标的权重,概率乘法计算组合权重。结果2轮专家咨询分别邀请了20和26名专家参加,2轮专家权威系数分别为0.955和0.968,专家意见协调系数P<0.05。最终确定的指标框架包括5个一级指标,19个二级指标,42个三级指标。一级指标中的“政府主导”、“联防联控”、“监测与响应”、“能力建设”、“组织保障”,权重分别为20.2%,2.4%,20.1%,44.7%和12.5%。二级指标中组合权重最高的为“能力建设”下占比25.0%的“医疗机构”,最低为“联防联控”指标下的“跨部门合作”为0.3%。三级指标中组合权重较高的3个指标为:“1.2.1防止疟疾输入再传播工作有规划,相关部门职责清晰”占14.9%,“4.1.4医疗机构检验人员具备疟疾镜检能力”占10.6%,“4.2.1设有疟疾检测实验室,具备疟疾检测能力”占7.6%。结论本研究构建了针对我国除边境地区外的县区输入性疟疾防止再传播技术指标框架。框架从政府主导、联防联控、监测与响应、能力建设及组织保障多个维度,为县区提供了可操作、科学、综合的实践指引,强调了消除后阶段疟疾防止再传播能力维持、医防协同下全流程病例管理的重要性。Objective The objective of this research is to construct a technical indicator framework for preventing the of re-establishment of imported malaria at the county level in China,excluding border areas,with the aim of guiding specialist agencies to prevent the re-establishment of imported malaria in a scientific,feasible and comprehensive way.Methods The preliminary framework was built based on literature review and on-site research.Two rounds of Delphi consultation were carried out.The positive coefficient,degree of concentration,degree of coordination,and authority of the experts were calculated.The weights and the combined weights for the indicators were determined using the analytic hierarchy process and probability method,respectively.Results Twenty experts were invited in the 1st round of consultation,and twenty-six in the 2nd round.The authority coefficients of the experts for two rounds were 0.955 and 0.968,respectively.The P value of the degree of coordination of two rounds were less than 0.05.The final framework included 5 primary indicators,19 secondary indicators and 42 tertiary indicators.Primary indicators included government-led,joint control and prevention,surveillance and response,capacity building and organization guarantee,whose weights were 20.2%,2.4%,20.1%,44.7%and 12.5%,respectively.Among the secondary indicators,the highest combined weight was medical institutions(25.0%)of capacity building,and the lowest was cross-sectoral cooperation(0.3%)of joint control and prevention.The three tertiary indicators with higher combined weights were:"1.2.1 There is a comprehensive plan for preventing the re-establishment of imported malaria,and the responsibilities of relevant departments are clearly defined"accounting for 14.9%;"4.1.4 Laboratory personnel in medical institutions possess the ability to conduct microscopic examinations for malaria detection"accounting for 10.6%;and"4.2.1 Specialized malaria surveillance laboratories have been established and are fully equipped with the necessary capabilities

关 键 词：输入性疟疾 再传播 指标框架 德尔菲法 层次分析法 

分 类 号：R254.5[医药卫生—中医内科学]