2015—2021年辽宁省疟疾诊断参比实验室疟疾样本复核结果

doi:10.11853/j.issn.1003.8280.2024.05.013

摘要/Abstract

摘要： 目的对2015—2021年辽宁省各地市上报的疟疾病例样本,在省级参比实验室进行检测复核,并根据实验结果评估各地市疟疾诊断参比实验室的疟疾诊断能力,为进一步提升各地市疾病预防控制（疾控）中心疟疾诊断能力提供参考依据。方法对上报的血涂片样本进行镜检复核,疟疾病例的抗凝血样本进行巢式PCR和荧光定量PCR（qPCR）检测,采用χ²检验和Fisher确切概率法对各组间检出率、检出率与上报阳性率间差异进行统计学分析。结果 2015—2021年累计复核380份疟疾病例样本,其中恶性疟阳性样本270份,间日疟20份,三日疟11份,卵形疟34份,阴性45份。上报病例样本主要集中在沈阳和大连市,共278份,占全省病例总数的73.16%。对各地市实验室检测的复核结果分析显示,沈阳市检测符合率为95.36%,大连市为92.97%,全省实验室平均符合率为90.13%。比较镜检和巢式PCR 2种方法的结果,巢式PCR检测阳性率为87.63%,血涂片镜检阳性率为74.47%,2种方法检出率差异有统计学意义（χ²=46.296,P<0.001）。结论辽宁省各地市疾控中心在血涂片镜检和核酸检测能力虽然逐步提高,但检测水平不均衡,仍然有较大的提升空间,需继续加强实验室人员检测能力培训,稳固实验室检测队伍人员应有的检测水平,做到送检样本的及时精准检测与反馈,巩固疟疾消除成果。

关键词: 疟疾, 参比实验室, 符合率, 复核结果, 辽宁省

Abstract: Objective To assess the diagnostic capacities for malaria of prefecture-level malaria diagnostic reference laboratories of Liaoning Province, China by checking the samples from malaria cases provided by each city from 2015 to 2021 at the provincial reference laboratory, so as to provide a basis for further improving the malaria diagnostic capacity of the centers for disease control and prevention in each city. Methods The blood smear samples were checked under a microscope, and the anticoagulated blood samples from malaria cases were tested using nested PCR and quantitative real time PCR. The Chi-square test and Fisher's exact test were used to compare the detection rate between groups, and to compare the detection rate and reported positive rate. Results A total of 380 samples from malaria cases were checked from 2015 to 2021, in which 270 were positive for Plasmodium falciparum, 20 were positive for P. vivax, 11 were positive for P. malariae, 34 were positive for P. ovale, and 45 were negative. The samples were mainly from Shenyang and Dalian, with a total of 278 samples, accounting for 73.16% of all the samples of the province. The check results showed that the coincidence rate was 95.36% for Shenyang and 92.97% for Dalian, and the average coincidence rate of all the laboratories was 90.13%. The positive rate by nested PCR was 87.63%, and the positive rate by blood smear microscopy was 74.47%, which were significantly different (χ²=46.296, P<0.001). Conclusions Although progress has been made in the capabilities of blood microscopy and nucleic acid detection of prefecture-level centers for disease control and prevention of Liaoning Province, their detection levels are imbalanced, and there is still a large room for improvement. In order to consolidate the malaria elimination achievements, it is necessary to continue to strengthen laboratory personnel training on testing ability, stabilize the testing level, and make sure timely and accurate detection and feedback.

Key words: Malaria, Reference laboratory, Coincidence rate, Specimen check, Liaoning Province

中图分类号:

R183.5

王博, 孙英伟, 李鑫, 王子江, 于维君, 雷露, 于伟, 毛玲玲. 2015—2021年辽宁省疟疾诊断参比实验室疟疾样本复核结果[J]. 中国媒介生物学及控制杂志, 2024, 35(5): 581-586.

WANG Bo, SUN Ying-wei, LI Xin, WANG Zi-jiang, YU Wei-jun, LEI Lu, YU Wei, MAO Ling-ling. Review results of malaria samples by Liaoning provincial malaria diagnostic reference laboratories in Liaoning Province, 2015-2021[J]. Chinese Journal of Vector Biology and Control, 2024, 35(5): 581-586.

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