摘要
目的分析2018-2020年郑州市输入性疟疾病例诊断情况,巩固消除疟疾后疟原虫诊断能力,进一步提高诊断准确率。方法收集2018-2020年郑州市各辖区上送疟疾病例的血液样本和血涂片,分别采用疟疾快速诊断试纸条(RDT)、显微镜镜检、聚合酶链式反应(PCR)方法复核,以省级参比实验室诊断结果为标准,分析不同检测方法及各级检测机构复核情况。结果2018-2020年郑州市疟疾诊断实验室共复核204例疟疾样本,确诊阳性177例,检测阳性率为86.76%(177/204),2018-2020年各年度检测阳性率分别为82.05%、89.11%、92.00%。确诊病例中,恶性疟占比最高为72.88%(129/177),其次为卵形疟占18.64%(33/177),间日疟、三间疟和混合感染分别占3.95%(7/177)、3.95%(7/177)和0.56%(1/177)。RDT、显微镜镜检、PCR法三种检测方法的诊断符合率差异无统计学意义(χ^(2)=2.273,P>0.05);医疗机构(82.35%)及县(83.82%)、市(88.73%)疾控机构检测符合率差异无统计学意义(P>0.05)。结论消除疟疾后,各级机构诊断能力仍需巩固提高。应继续加强镜检技能培训,并逐步开展核酸检测,提升输入性疟疾诊断水平。
Objective The diagnosis of imported malaria cases in Zhengzhou from 2018 to 2020 was analyzed to consolidate the diagnostic ability of malaria parasite after malaria elimination and further improve the diagnostic accuracy.Methods Blood samples and blood smears of malaria cases were collected and rechecked by rapid diagnostic strip test(RDT),microscopic examination and polymerase chain reaction(PCR)method.The results of provincial reference laboratories were taken as the standard to analyze different detection methods and the recheck results of testing institutions at all levels.Results A total of 204 malaria samples re-examined by Zhengzhou City Malaria Diagnostic Laboratory from 2018 to 2020,among them 177 malaria cases were conformed.The positive rate was 86.76%(177/204).From 2018 to 2020,the positive rate were 82.05%,89.11%,92.00%.Among the conformed cases,Plasmodium falciparum accounted for the highest(72.88%,129/177),followed by Plasmodium ovale(18.64%,33/177).The proportions of Plasmodium vivax,Plasmodium malariae and mixed infection were 3.95%(7/177),3.95%(7/177)and 0.56%(1/177).There was no statistical difference between diagnostic composite rate of RDT,microscopic examination and PCR methods(χ^(2)=2.273,P>0.05).There was no significant difference in detection results between medical institutions(82.35%)and county-level(83.82%)and city-level(88.73%)centers for disease control(CDC)(P>0.05).Conclusions After the elimination of malaria,the diagnostic capabilities of institutions at all level still need to be improved.The training of microscopy skills and nucleic acid testing should be strengthened to improve the diagnostic efficiency of imported malaria cases.
作者
赵雪蕾
李素华
牛卫东
周鹏
安戈
ZHAO Xue-lei;LI Su-hua;NIU Wei-dong;ZHOU Peng;AN Ge(Zhengzhou Center for Disease Control and Prevention,Zhengzhou,Henan 450000;Henan Center for Disease Control and Prevention,Zhengzhou,Henan 450016,China)
出处
《热带医学杂志》
CAS
2022年第9期1284-1287,共4页
Journal of Tropical Medicine
基金
河南省医学科技攻关计划联合共建项目(LHGJ20190706)
关键词
疟疾
输入性
镜检
RDT
PCR
Malaria
Imported cases
Microscopy examination
RDT
PCR
