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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。
Objective To compare the application of three methods of Plasmodium microscopy, rapid antigen test (RDT) and nucleic acid detection (PCR) in Shanghai municipal and district-level CDC (Centers for Disease Control and Prevention) to evaluate the malaria laboratory test Ability to analyze. Methods Shanghai Municipal CDC collected blood smear, whole blood blood samples, confirmed case record and epidemic data of malaria cases in Shanghai in 2012-2015 for malaria cases and suspected malaria cases. The test results were compared and analyzed. Results From 2012 to 2015, a total of 212 samples with complete data were sent to all districts and counties in Shanghai. The samples sent in Jinshan District were the highest (41.98%) in each district and county, and the highest rate was 82.07% in tertiary hospitals. From January to October, the number of samples submitted for inspection gradually increased. The municipal CDC tested 212 blood samples by microscopy, RDT and PCR simultaneously, and determined a total of 167 samples (78.77%) and 45 negative samples (21.23%) for the malaria samples. There were 153 positive samples (72.17%) of malaria positive samples, including 41 (19.34%) positive samples and 53 (25.00%) negative samples, which were undetected by microscopy and domestic RDT 6 (2.83%). Reported that the hospital and district CDC microscopic examination coincidence rate was 78.16%, CDC CDC CDC and City CDC examination coincidence rate was 93.20%; District RDT use rate was 73.58%, domestic RDT test and City CDC RDT detection compliance rate was 93.59%. City CDC test results as a standard, district-level laboratory miscarriage of justice 37. 99.37% of malaria confirmed cases were imported overseas, including Africa (85.44%), Asia (13.92%) and the Americas (0.63%). Conclusion The monitoring of post-malaria elimination in Shanghai should be integrated with a variety of testing methods to integrate resources.