2012-2015年上海市实验室疟疾检测能力比较分析

发布时间：2019-03-19 15:17

【摘要】：目的比较疟原虫镜检、抗原快速检测(RDT)和核酸检测(PCR)3种方法在上海市级和区县级疾病预防控制中心(疾控中心)的应用情况,对该市疟疾实验室检测能力进行分析。方法由上海市疾控中心收集2012-2015年上海市疟疾病例和疑似疟疾病例的血涂片、全血血样、病例复核确认记录单和上海市疟疾病例疫情资料,并对检测结果进行比较分析。结果 2012-2015年,上海市各区县共送检数据完整的样本212份,各区县中以金山区送样量最多(41.98%),报告医院以三级医院送样量最多(82.07%);1-10月间送检样本量逐渐增多。市疾控中心对212份血样均采用显微镜检、RDT和PCR 3种方法同时进行检测,综合判定疟疾确诊样本共计167份(78.77%),阴性样本45份(21.23%)。区县级实验室使用显微镜检和国产RDT对样本进行检测,判定疟疾阳性样本153份(72.17%),其中阳性未分型41份(19.34%),阴性样本53份(25.00%),未检测6份(2.83%)。报告医院与区县疾控中心镜检符合率为78.16%,区县疾控中心与市疾控中心镜检符合率为93.20%;区县级实验室RDT使用率为73.58%,国产RDT检测和市疾控中心进口RDT检测的符合率为93.59%。以市疾控中心检测结果作为标准,区县级实验室误判37份。99.37%的疟疾确诊病例为境外输入,包括非洲(85.44%)、亚洲(13.92%)和美洲(0.63%)。结论上海市消除疟疾后的监测工作应结合多种检测方法,整合资源开展。
[Abstract]:Aim to compare the application of Plasmodium malaria microscopic examination, rapid detection of antigen (RDT) and nucleic acid detection of (PCR) in Shanghai Municipal and Regional Centers for Disease Control and Prevention (CDC), and to analyze the laboratory detection capability of malaria in Shanghai. Methods the blood smears of malaria cases and suspected malaria cases in Shanghai from 2012 to 2015 were collected from the Center for Disease Control and Control of Shanghai. The whole blood samples, the record of case review confirmation and the epidemic situation of malaria cases in Shanghai were collected. The results were compared and analyzed. Results from 2012 to 2015, 212 samples were sent to every district and county in Shanghai. Jinshan District was the most (41.98%), and the third-level hospital was the largest (82.07%). From January to October, the number of samples sent for examination increased gradually. A total of 167 (78.77%) confirmed malaria samples and 45 negative (21.23%) samples were detected simultaneously by RDT and PCR methods, and all blood samples were examined by microscope, and the results showed that the total number of confirmed malaria samples was 78.77% (78.7%) and 21.23% (45 / 212) respectively. The laboratory at county level detected 153 positive samples (72.17%) by microscope and domestic RDT, of which 41 (19.34%) were positive and 53 (25.00%) were negative. 6 cases (2.83%) were not detected. It was reported that the coincidence rate of microscopic examination was 78.16% in hospitals and CDC centers in districts and counties, 93.20% in CDC centers in districts and counties and in CDC centers in cities and counties. The utilization rate of RDT was 73.58%, and the coincidence rate between domestic RDT and imported RDT in CDC was 93.59%. According to the test results of CDC, 37 cases of malaria were misjudged by laboratory at district and county level. 99.37% of confirmed malaria cases were imported abroad, including Africa (85.44%), Asia (13.92%) and the Americas (0.63%). Conclusion the surveillance work after malaria elimination in Shanghai should be carried out in combination with multiple detection methods and integrated resources.
【作者单位】：上海市疾病预防控制中心;
【分类号】：R531.3

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