Abstract:

Objective To understand the conditions of schistosomiasis laboratories at county level so as to supply the information for diagnostic capacity building. Methods A questionnaire survey was conducted at 40 random selected counties which were in charge of national surveillance for schistosomiasis. The information of staffs, areas of laboratories, equipment configuration and diagnostic methods from each laboratory were collected. The serum specimens and Kato-Katz thick smears from the national surveillance sites were random selected and retested by provincial staffs to evaluate the testing ability of the personnel. Results The average age of laboratory staffs was 40.93±9.56 years old, and 69.39% of staffs were old than 35 years and 86.22% of them had education background below bachelor degree. Except missed professional titles of four persons, the staffs with primary, middle and high professional titles accounted for 56.63%, 39.29%, and 2.04%, respectively. The laboratory areas varied greatly while independent schistosomiasis stations had the lowest areas with 52.81±40.08 m2, and the equipment configurations of laboratories were in a low level. The consistency rates of primary test and reexamination for serum specimens and thick smear slides were 95.89% and 99.53%, respectively, with the kappa value over 0.90. Nine immunodiagnostic kits were used in these laboratories, and Kato-Katz technique and miracidium hatching technique were the main parasitological methods. Conclusions The personnel structure of laboratories at primary prevention and treatment facilities for schistosomiasis is unreasonable, while the basic infrastructure of laboratories is backward and the use of diagnostic assays/methods is disordered. The diagnostic capacity building should be strengthened, and the construction and management of schistosomiasis laboratories should be standardized.

Key words: Schistosomiasis, Capacity building, Diagnosis, Primary prevention and treatment facility, Surveillance sites

摘要：

目的 了解我国县级血吸虫病防治机构血吸虫病诊断实验室建设及诊断能力现状，为国家和省级有关部门制订卫生（血防）政策、优化卫生资源配置提供依据。 方法 随机抽取40个国家级血吸虫病监测点所在的县级血防专业机构实验室，通过问卷调查等方式调查实验室人员、用房面积、仪器设备配置情况及常用血吸虫病诊断方法等信息；抽取各监测点10%的居民查病血清样本和改良加藤片样本进行复检，评估县级血防机构检验人员的检测水平。 结果 监测点所在各县级血防专业机构实验室人员平均年龄为（40.93±9.56）岁，其中＞35岁占69.39%；86.22%的人员学历在本科以下（不含本科）；除4人职称不明外，初级、中级、高级职称比例分别为56.63%、39.29%和2.04%。各地实验室面积差别较大，以独立县级血吸虫病防治所/站实验室面积最小、仅为（52.81±40.08） m2，且实验室仪器设备配置水平较低。各实验室血清样本和改良加藤片样本复检符合率分别为95.89%和99.53%，kappa值均＞0.90。现场使用的免疫诊断试剂达9种，病原学检测以改良加藤法和尼龙绢集卵孵化法为主。结论 基层血防机构实验室人员结构不合理，基础建设落后，诊断试剂/方法使用现状混乱。各地应加强实验室诊断能力建设，规范实验室建设和管理。

关键词: 血吸虫病, 能力建设, 诊断, 基层防治机构, 监测点