2018年湖北省基层手足口病报告数据质量分析

目的 了解湖北省基层手足口病病例报告情况和病原检测方法,探讨提高手足口病监测数据质量的方法。方法 采用分层抽样的方法在湖北省抽取北部3个地区,中部3个地区和南部1个地区的16所医疗机构的160例手足口病病例,核对分析医疗机构病例信息与中国疾病监测信息报告管理系统报告的病例信息的报告率、及时性和一致性。描述分析基层医疗机构手足口病病原学检测结果与疾病预防控制中心手足口病病原检测结果。结果 共核查8所县级医疗机构和8所乡镇级医疗机构诊疗登记的手足口病病例160例。2018年基层医疗机构手足口病报告率为96.25%(154/160),县级医疗机构和乡镇级医疗机构手足口病报告率均为96.25%;报告及时率为87.50%(140/160),县级医疗机构报告及时率为88.75%(71/80),乡镇级医疗机构报告及时率为86.25%(69/80),差异无统计学意义;报告一致率为88.75%(142/160),县级医疗机构报告一致率为85.00%(68/80),乡镇级医疗机构报告一致率为92.50%(74/80),差异无统计学意义。基层医疗机构中均不具备手足口病核酸检测能力,87.50%(14/16)的医疗机构开展胶体金检测,其中75.00%的医疗机构仅检测EV71。医疗机构ELISA法EV71阳性检出率高于CV16,疾病预防控制中心核酸检测以其它肠道病毒为主,且CV16阳性检出率高于EV71。结论 湖北省基层医疗机构手足口病报告情况较好,可加强信息化建设来提高数据质量。建议加强医疗机构手足口病病原核酸检测能力,提高医务人员手足口病诊断报告质量。

Quality of reporting hand-foot-mouth disease,Hubei,2018

Objective To investigate the quality of Hand-foot-mouth disease(HFMD)reporting and pathogen detection by the basic level medical institutions in Hubei,and to explore the methods to improve the quality of HFMD surveillance data.Methods 160 cases of HFMD were collected from 16 medical institutions in three northern regions,three central regions and one southern region of Hubei Province by stratified sampling method.The reporting rate,timeliness and consistency of the case information of the basic level medical institutions and the case information reported by the Infectious Disease Reporting Information Management System were analyzed.The results of pathogenic detection of HFMD in the basic level medical institutions and the results of pathogenic detection of HFMD in CDC were described and analyzed.Results A total of 160 cases of HFMD in 8 county-level medical institutions and 8 township level medical institutions were factual investigated.In 2018,the reporting rate of HFMD at the basic level medical institutions was 96.25%(154/160),of which the county level and the township level medical institutions were both 96.25%.The timely reporting rates were 87.50%(140/160),88.75%(71/80)in county-level and 86.25%(69/80)in township county level,with no significant difference.The consistency rate of reports was 88.75%(142/160),85.00%(68/80)in county-level and 92.50%(74/80)in township level,with no significant difference.No basic level medical institutions had the ability to conduct HFMD nucleic acid test.87.50%(14/16)of the medical institutions tested colloidal gold for HFMD,of which 75.00% of the medical institutions only detect EV71.The positive detection rate of EV71 by ELISA in medical institutions was higher than that of CV16.The nucleic acid test of CDC was mainly for other enteroviruses,and the positive rate of CV16 was higher than that of EV71.Conclusion The report of HFMD in basic level medical institutions in Hubei Province is relatively well,and information construction can be strengthened to improve data quality.It is necessary for strengthening the HFMD nucleic acid laboratory capacity of medical institutions and enhancing the quality of HFMD diagnosis reports produced by medical staff.