2017-2019年湖北省疟疾诊断参比实验室病例复核结果分析

目的　分析湖北省疟疾诊断参比实验室对网络报告疟疾病例的复核结果，为进一步提高全省疟疾防控水平提供科学依据。 方法　由湖北省疟疾诊断参比实验室对全省2017—2019年网络报告疟疾病例样本采用镜检和巢式PCR法进行复核，并分析病例和虫种等符合情况。 结果　2017—2019年，湖北省共有网络报告疟疾病例410例；湖北省疟疾诊断参比实验室共复核407例样本，确诊疟疾病例374例，总体疟疾诊断阳性符合率为91.89%（374/407）、虫种符合率为89.04%（333/374）；不同市（州）报告疟疾病例复核阳性符合率为50.00%～100.00%、虫种符合率为66.67%～100.00%，差异均有统计学意义（χ2 = 40.46、42.30，P均 < 0.01）；恶性疟原虫、间日疟原虫、三日疟原虫、卵形疟原虫复核虫种符合率分别为95.80%、100.00%、58.33%和51.92%，差异有统计学意义（χ2 = 76.66，P < 0.01）；镜检法与巢式PCR法检测结果一致率为89.83%（362/403）。结论　湖北省各级医疗卫生机构疟疾诊断质量总体较高，但部分地区诊断能力仍有待提高。

Re-examination of malaria diagnosis in Hubei Provincial Malaria Diagnostic Reference Laboratory from 2017 to 2019

Objective　To analyze the re?examination results of malaria cases captured from the National Notifiable Communicable Disease Reporting System in Hubei Provincial Malaria Diagnostic Reference Laboratory from 2017 to 2019, so as to provide the scientific evidence for improving the malaria control capability in the province. Methods　Microscopy and nested PCR assay were performed to re?examine the diagnosis of malaria cases registered in the National Notifiable Communicable Disease Reporting System in Hubei Provincial Malaria Diagnostic Reference Laboratory from 2017 to 2019, and the coincidences of malaria diagnosis and malaria parasite species were evaluated. Results　A total of 410 malaria cases were reported in Hubei Province from 2017 to 2019 according to the data retrieved from the National Notifiable Communicable Disease Reporting System. Among the 407 samples re?examined by Hubei Provincial Malaria Diagnostic Reference Laboratory from 2017 to 2019, the diagnosis 374 malaria cases were confirmed, with an overall coincidence of 91.89% (374/407) for malaria diagnosis and 89.04% (333/374) for parasite species identification. The coincidence rates of malaria diagnosis and parasite species identification were 50.00% to 100.00% and 66.67% to 100.00% in 16 cities (prefectures) of Hubei Province during the re?examinations, which both varied in regions (χ2 = 40.46 and 42.30, both P values < 0.01). The coincidence rates of Plasmodium falciparum, P. vivax, P. malariae and P. ovale identification were 95.80%, 100.00%, 58.33% and 51.92% during the re?examinations, respectively (χ2 = 76.66, P < 0.01). The consistency rate between microscopic and nested PCR results was 89.83% (362/403). Conclusion　The overall diagnostic quality of malaria is high in medical institutions at all levels in Hubei Province; however, the diagnostic capability of malaria remains to be improved in some regions.