【摘要】：目的分析云南省的省、縣兩級(jí)實(shí)驗(yàn)室瘧疾鏡檢診斷質(zhì)量及影響因素。方法 2012年8月-2014年10月,云南省各疫情報(bào)送單位采集鏡檢確診為瘧疾的患者血樣,制作血涂片和濾紙血送至省級(jí)瘧疾參比實(shí)驗(yàn)室進(jìn)行鏡檢和基因檢測,并統(tǒng)計(jì)分析省、縣兩級(jí)實(shí)驗(yàn)室瘧疾診斷的符合性。結(jié)果 2012年8月-2014年10月云南省的72個(gè)縣鏡檢確診瘧疾病例1 400例,其中惡性瘧、間日瘧和未分型瘧疾分別占18.4%(252/1 400)、79.3%(1 105/1 400)和3.1%(43/1 400),未分型瘧疾比例最高為2012年的3.5%(9/257)。2012年云南各縣與省級(jí)瘧疾參比實(shí)驗(yàn)室瘧原蟲鏡檢結(jié)果的蟲種符合率為70.1%(845/1 216),為2012-2014年期間的最低水平,血片瘧原蟲陽性符合率為77.6%(943/1 216)。各縣的瘧原蟲鏡檢結(jié)果與省級(jí)實(shí)驗(yàn)室基因檢測的蟲種符合率、陽性符合率也是2012年最低,分別為81.3%(150/185)和85.0%(157/185)。省級(jí)實(shí)驗(yàn)室鏡檢與基因檢測結(jié)果的不符合率為8.7%(97/1 120),不符合類型中以鏡檢陰性而基因檢測為惡性瘧原蟲、間日瘧原蟲或惡性瘧/間日瘧原蟲混合感染為主,占57.7%(56/97)。各縣采集瘧疾病例血樣的覆蓋率最低為2012月11月的46.9%(82/175)。2012-2014年全省血涂片制作質(zhì)量得分分別為69.8、70.4和78.8(P0.05)。結(jié)論 2013年后除個(gè)別縣外,云南省的縣級(jí)瘧疾實(shí)驗(yàn)室診斷各環(huán)節(jié)的工作質(zhì)量均顯著提高。
[Abstract]:Objective to analyze the diagnostic quality and influencing factors of malaria microscopic examination in provincial and county laboratories in Yunnan province. Methods from August 2012 to October 2014, blood samples were collected from malaria patients diagnosed by microscope in Yunnan Province, and blood smear and filter paper were made for transmission to provincial malaria reference laboratory for microscopic examination and gene detection. Conformance of malaria diagnosis in laboratory at county level. Results from August 2012 to October 2014, 1,400 malaria cases were confirmed by microscopic examination in 72 counties of Yunnan Province, including falciparum malaria. Vivax malaria and untyped malaria accounted for 18.4% (252 / 1 400) and 3.1% (43 / 1 400), respectively. The highest proportion of untyped malaria was 3.5% (9 / 257) in 2012. In 2012, the coincidence rate of malaria parasites in Yunnan counties and provincial malaria reference laboratories was 70.1% (8451,216), the lowest level in 2012-2014. The positive coincidence rate of Plasmodium falciparum was 77.6% (943 / 1 216). The results of microscopic examination of Plasmodium falciparum were the lowest in 2012, which were 81.3% (150 / 185) and 85.0% (157 / 185) respectively. The mismatch rate between microscopic examination and gene detection in provincial laboratory was 8.7% (97 / 1 120). The negative results were detected as falciparum and the co-infection of Plasmodium vivax or falciparum / Plasmodium vivax accounted for 57.7% (56 / 97). The lowest blood sample coverage rate of malaria cases was 46.9% (82 / 175) in November, 2012.The blood smear quality scores of the whole province from 2012 to 2014 were 69.8% and 78.8 (P0.05) respectively. Conclusion after 2013, the quality of diagnosis in malaria laboratory at county level in Yunnan Province has been improved significantly except in some counties.
【作者單位】： 云南省寄生蟲病防治所云南省瘧疾研究中心云南省蟲媒傳染病防控研究重點(diǎn)實(shí)驗(yàn)室;
【分類號(hào)】：R531.3

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