| 2016年新疆维吾尔自治区南疆五地区伤寒、副伤寒报告病例诊断准确性调查 |
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| 引用本文： | 李方,施国庆,木合亚提·胡塞英,常昭瑞,马合木提. 2016年新疆维吾尔自治区南疆五地区伤寒、副伤寒报告病例诊断准确性调查[J]. 疾病监测, 2017, 32(8): 629-633. DOI: 10.3784/j.issn.1003-9961.2017.08.005 |
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| 作者姓名： | 李方,施国庆,木合亚提· 胡塞英,常昭瑞,马合木提 |
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| 作者单位： | 1.新疆维吾尔自治区疾病预防控制中心, 新疆 乌鲁木齐 830002 |
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| 摘 要： | 目的 了解新疆维吾尔自治区（新疆）南疆五地区伤寒监测系统报告病例的准确性，以及基层医疗机构对伤寒、副伤寒的诊断能力和水平。方法 将南疆五地区所有医院报告的发病日期为2016年1月1日至8月31日的伤寒、副伤寒的临床和确诊病例的流行病学个案调查表与国家伤寒、副伤寒诊断标准进行比较，核实病例诊断的准确性。抽取部分医院，通过访谈检验科医生，了解被抽中医院开展伤寒、副伤寒的实验室检测情况。对临床医生采用自行设计的调查问卷以面对面访谈的方式，询问医生对伤寒、副伤寒疾病的认知以及参加相关培训的情况。结果 调查结果显示南疆五地区2016年1月1日至8月31日上报的伤寒、副伤寒49例病例中，临床病例诊断正确率为6.67%（1/15），确诊病例诊断正确率为14.71%（5/34）。共调查32家医疗机构，乡镇级医院仅有5.88%（1/17）可开展细菌培养，100%均未开展肥达试验。调查的105名医生中对临床诊断病例定义的正确回答率只有7.62%，对确诊病例定义的正确回答率仅为11.43%。参加过培训的人员中对诊断标准的回答正确率高于未参加过培训的人员。结论 本次调查发现基层医疗机构开展细菌培养和肥达试验的比例均不高，而且医生对伤寒、副伤寒的诊断标准掌握不规范。建议县级疾病预防控制中心承担伤寒、副伤寒的核实和免费检测任务，对县（乡）级医院的医务人员应加强伤寒、副伤寒的培训，保证基层医生能及时做出疑似诊断报告，以保持发现疫情的敏感性。
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| 关 键 词： | 伤寒、副伤寒 诊断标准 南疆 |
| 收稿时间： | 2017-07-13 |
Investigation of diagnostic accuracy of typhoid and paratyphoid fever in five areas of south Xinjiang,2016 |
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| LI Fang,SHI Guo-qing,Muheyati,#;Husaiying,CHANG Zhao-rui,Mahe Muti. Investigation of diagnostic accuracy of typhoid and paratyphoid fever in five areas of south Xinjiang,2016[J]. Disease Surveillance, 2017, 32(8): 629-633. DOI: 10.3784/j.issn.1003-9961.2017.08.005 |
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| Authors: | LI Fang,SHI Guo-qing,Muheyati&# Husaiying,CHANG Zhao-rui,Mahe Muti |
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| Affiliation: | LI Fang,SHI Guo-qing,Muheyati·Husaiying,CHANG Zhao-rui,Mahe Muti |
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| Abstract: | Objective To understand the diagnostic accuracy of reported typhoid cases through surveillance system in five areas of south Xinjiang,and the performance of diagnosis and treatment of typhoid fever and paratyphoid fever in grass root medical institutions.Methods The clinical diagnosed and confirmed typhoid and paratyphoid cases reported in the five areas during January 1-August 31,2016 were evaluated according to the national typhoid and paratyphoid diagnosis criteria to verify the diagnosis accuracy.The performance of laboratory detection of typhoid and paratyphoid was surveyed in some hospitals.A questionnaire survey was conducted in clinical doctors to learn about their knowledge about typhoid and paratyphoid fever and information about related training.Results Of the 49 typhoid and paratyphoid fever cases reported in five areas of south Xinjiang during this period,the accuracy of clinical diagnosis was 6.67％ (1/15),and the accuracy of case confirmation was 14.71％ (5/34).A total of 32 medical institutions were investigated.Only 5.88％ (1/17) of township hospitals were able to carry out bacterial culture,and 100％ of them did not carry out Widal test.Of the 105 doctors surveyed,the correct answer rate for clinical case definition was only 7.62％,and the correct answer rate of case confirmation definition was only 11.43％.The doctors who had attended related training had higher correct answer rates compared with those who received no training.Conclusion This survey found that limited grass root medical institutions conducted bacterial culture and Widal test,and the doctors were not fully understood the diagnosis criteria of typhoid and paratyphoid fever.It is suggest to conduct free typhoid and paratyphoid verification and detection by county CDCs and strengthen the medical staff training in grass root medical institutions for the timely diagnosis of suspected cases and the sensitivity of outbreak detection. |
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| Keywords: | Typhoid,Paratyphoid Diagnosis criterion South Xinjiang |
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