Abstract: Objective To analyze the quality of malaria blood smears of febrile patients in Chenzhou city in order to provide a scientific basis for the standardization of blood test. Methods According to the technical solutions to eliminate malaria of 2011 edition, more than 3% Plasmodium negative blood smears and all Plasmodium positive blood smears were reviewed monthly from 2015 to 2017. The quality of blood smear preparation, staining, cleanliness and detection results were reviewed by malaria microscopic examination staff. The descriptive epidemiological method was used to analyze the data. The Chi square test was used to compare the rates, and P<0.05 was statistically significant. Results A total of 9 806 malaria blood tests among febrile patients were carried out in Chenzhou city in 3 years. Plasmodium negative blood smears were reviewed in the number of 518, accounting for 5.29% of all Plasmodium negative blood smears, with the production qualified rate of 77.80%, the staining pass rate of 89.58%, the cleanliness pass rate of 95.17%. No missed detection was found in Plasmodium negative blood smear review. Nine (9) Plasmodium positive blood smears were rechecked, accounting for 100% of all Plasmodium positive blood smears, and the qualified rate of production, staining and cleanliness all were 88.89%. One Plasmodium classification error was found in Plasmodium positive blood slides review. There were statistically significant differences among each county in the production qualified rates, the staining pass rates and cleanliness pass rates (χ²=87.286, 80.636, 81.023, all P<0.001). There were no statistically significant differences among each year in the production qualified rates and cleanliness pass rates (χ²=3.484, 1.941, both P>0.05). There were statistically significant differences among each year in the staining pass rates (χ²=6.521, P=0.038). Conclusion The production and staining of Plasmodium blood smears should be further standardized in Chenzhou in the future, the training and quality control of Plasmodium microscopy should be further strengthened to improve the quality and the accuracy of microscopic examination for malaria diagnosis.

Key words: Febrile patient, Plasmodium, Blood slide, Quality, Chenzhou city

摘要： 目的 分析郴州市"三热"患者（临床诊断为疟疾、疑似疟疾和不明原因发热的患者）疟原虫血片质量，为规范血检工作提供科学依据。方法 按照《消除疟疾技术方案（2011年版）》要求，2015-2017年每月抽取各县（市、区）≥ 3%疟原虫阴性血片和全部疟原虫阳性血片，由疟疾镜检专业人员对血片制作、染色、清洁度及镜检结果进行复核，采取描述流行病学方法对数据进行分析，率的比较采用χ²检验。结果 3年郴州市共开展"三热"患者疟原虫血检9 806人次，复核疟原虫阴性血片518张，占全部疟原虫阴性血片的5.29%，疟原虫阴性血片制作合格率为77.80%、染色合格率为89.58%、清洁度合格率为95.17%，未发现漏检；复核疟原虫阳性血片9张，占全部阳性血片的100%，制作合格率、染色合格率和清洁度合格率均为88.89%，复核发现疟原虫虫种分型错误1张。各县（市、区）血片制作、染色和清洁度合格率差异均有统计学意义（χ_制作²=87.286、χ_染色²=80.636、χ_清洁度²=81.023，均P<0.001）；各年度血片制作、清洁度合格率差异均无统计学意义（χ_制作²=3.484、χ_清洁度²=1.941，均P>0.05），各年度染色合格率差异有统计学意义（χ²=6.521，P=0.038）。结论 郴州市需进一步规范疟原虫血片的制作和染色环节，加强疟原虫镜检培训和质量控制，以提高血片质量和镜检准确性。

关键词: 发热患者, 疟原虫, 血片, 质量, 郴州市