云南省10州（市）消除疟疾考核评估镜检 和血片复核结果分析

［摘要］　目的 了解通过省级消除疟疾考核评估的云南省10个州（市）检验人员血片制作水平和镜检能力，为消除疟疾监测和疟原虫检测提供依据。方法 在云南省通过省级消除疟疾考核评估的10个州（市），每个州（市）随机抽取30张阴性血片进行血片涂制质量、染色质量、清洁度和结果判定复核；随机抽取每州（市）及所辖2个县（区）医院和疾病预防控制中心4名检验人员进行疟原虫显微镜检查技能考核，并对考核结果进行统计分析。结果 共复检阴性血片869张，复检符合率为100%，其中血片涂制质量、染色质量和清洁度好和中等级血片分别占96.09%、91.71%和96.89%；镜检技能考核共镜检读片576张，正确率为87.67%，其中间日疟原虫、恶性疟原虫和混合感染血片镜检读片正确率分别为87.76%、87.50%和47.62%，镜检人员对不同疟原虫虫种的检测能力差异有统计学意义（χ2] = 37.169，P < 0.05），来自疾病预防控制中心、医院和卫生院的镜检人员对疟原虫的检测能力差异无统计学意义（χ2] = 2.782，P > 0.05），来自州（市）级、县（区）级和乡（镇）级机构的检验人员疟原虫镜检能力差异无统计学意义（χ2] = 0.358，P > 0.05）。结论 云南省10个州（市）疟原虫血片制作和镜检技能考核已达到省级消除疟疾考核评估中的指标要求，但还需进一步提高各级医疗卫生机构检验人员的疟原虫血片制作和镜检技能。

Results of microscopic examinations and blood slide re-examinations of malaria elimination evaluation in ten prefectures of Yunnan Province

Objective To understand the laboratory technicians’ abilities in blood slide making and reading in 10 prefectures of Yunnan Province which have passed the provincial malaria elimination evaluation， so as to provide the evidence for improving the malaria elimination surveillance and parasite examination. Methods Thirty negative blood slides were randomly sampled to evaluate coating， dyeing and clean quality and reading results， and 4 laboratory technicians were sampled to evaluate their reading abilities from each prefecture level and its 2 subordinate counties （districts） respectively， and then the results were analyzed. Results A total of 869 negative blood samples were evaluated. The coincidence rate was 100%. The proportions of good coating， dyeing and clean quality were 96.09%， 91.71% and 96.89%， respectively. Totally 576 blood slides were used to evaluate the reading ability. The number of correct reading was 505， and the correct rate was 87.67%. Among them， the Plasmodium vivax correct reading rate was 87.76%， the P. falciparum correct reading rate was 87.50%， and the correct reading rate of mixed infections was 47.62%. The laboratory technicians’ ability to the mixed infections was significantly lower than the ability to the others （χ2] = 37.169， P < 0.05）， however， in the laboratory technicians’ abilities， there was no significant difference among the center（s） for disease control and prevention， general hospitals and township hospitals （χ2] = 2.782， P > 0.05）， and the prefecture， county and township levels （χ2] = 0.358， P > 0.05）. Conclusion The 10 prefectures have passed the provincial evaluation in blood slide making and microscopic examination skill indicators requested， but the medical and public health institutions at all levels still should further improve their laboratory technicians’ abilities in blood slide making and microscopic examination skills.