Chin J Schisto Control ›› 2013, Vol. 25 ›› Issue (1): 11-15.

Previous Articles     Next Articles

Assessment of effect and quality control for paracitological tests in national schistosomiasis surveillance sites

  

  1. National Institute of Parasitic Diseases|Chinese Center for Disease Control and Prevention;Key Laboratory of Parasite and Vector
    Biology|Ministry of Public Health;WHO Collaborating Center for Malaria|Schistosomiasis and Filariasis|Shanghai 200025|
    China
  • Online:2013-03-04 Published:2013-03-05

全国血吸虫病监测点现场病原学检测效果及质控评估

朱蓉|秦志强|冯婷|党辉|张利娟|许静*   

  1. 中国疾病预防控制中心寄生虫病预防控制所|卫生部寄生虫病原与媒介生物学重点实验室|世界卫生组织疟疾、血吸虫病和丝虫病合作中心(上海200025)
  • 作者简介:朱蓉|女|副研究员。研究方向:血吸虫病流行病学

Abstract:

Objective To understand the ability of pathogenic diagnosis for schistosomiasis japonica in the national surveil?
lance sites and evaluate the effect of stool hatching method in the field,so as to provide the evidence for establishing a quality con?
trol system of pathogenic diagnosis of schistosomiasis in the surveillance sites. Methods The data pertaining to the parasitologi?
cal diagnosis of the residents with positive serological tests were collected in 81 national surveillance sites of 12 provinces in 2011,
and the effects of the Kato?Katz technique and stool hatching method were evaluated and compared. The incubation quality control
samples made by the national schistosomiasis diagnosis reference laboratory were detected by both Kato?Katz technique and stool
hatching method using the single?blind method,and the results were analyzed and compared for the coincidence rate,misdiagno?
sis rate and missing diagnosis rate in all the county laboratories in 2012. Results A total of 3 780 sero?positive residents were
tested by using the Kato?Katz technique and stool hatching method in the 81 national surveillance sites in 2011,127 persons were
double egg?positive,3 513 persons were double egg?negative,and the total coincidence rate was 96.30%. Totally 173 infected peo?
ple were diagnosed by using the Kato?Katz technique and the positive detection rate was 4.58%;221 infected people were diag?nosed by using the stool hatching method and the positive detection rate was 5.85%. A total of 267 positive people were diagnosed
by the Kato?Katz technique or the stool hatching method or both and the total positive detection rate was 7.06%,which was higher
by 54.15% than that by using the single Kato?Katz technique( χ2 = 21.32,P < 0.01). In 2012,of 240 standard incubation quality
control samples(160 positives,80 negatives)detected by the technicians from the 80 surveillance sites,105 samples were posi?
tive and 67 samples were negative,with a total coincidence rate of 71.67%(172/240)and a total missing diagnosis rate of 34.38%
(55/160). Among them,the missing rate of the strong positive samples was 32.50%(26/80),the missing rate of the weakly posi?
tive samples was 36.25%(29/80),and the misdiagnosis rate of the negative samples was 16.25%(13/80). The detection rates of
the incubation quality control samples were 61.11%,80.00%,77.08%,90.48%,58.33% and 59.26% in the surveillance sites of
six provinces,including Anhui,Hubei,Hunan,Jiangsu,Jiangxi and Sichuan provinces,respectively,and a significant differ?
ence was found( χ2 = 14.27,P < 0.05). Conclusions The detection efficiency of the stool hatching method is superior to that of
the Kato?Katz technique in the field. However,the levels of the technical personnel for the stool hatching method are relatively low
in most of the surveillance sites. Therefore,the technical training should be strengthened.

Key words: Schistosomiasis;Diagnosis;Kato?Katz technique;Stool hatching method;Quality control

摘要:

目的 了解全国血吸虫病监测点血吸虫病病原学检测能力,评价尼龙绢集卵孵化法现场检测效果,为建立血吸虫病监测点病原学诊断质控体系提供参考依据。方法 收集2011年全国12个省(市、自治区)81个血吸虫病监测点血检阳性居民病原学检查资料,分析Kato?Katz法和尼龙绢集卵孵化法的检测效果;由各监测点采用单盲法检测国家血吸虫病诊断参比实验室统一提供的血吸虫虫卵孵化质控样本,比较两种病原学诊断方法检测的符合率、误检率和漏检率。结果2011年全国81个血吸虫病监测点共采用Kato?Katz法和尼龙绢集卵孵化法检测3 780例血检阳性居民,查出双阳性127例,双阴性3 513例,总符合率为96.30%;其中Kato?Katz法检出阳性173例,阳性率为4.58%;尼龙绢集卵孵化法检出阳性221例,阳性率为5.85%。两法共检出阳性267例,总阳性检出率为7.06%,较单纯Kato?Katz法阳性检出率提高54.15%( χ2 = 21.32,P < 0.01)。2012年全国12个省(市、自治区)80个血吸虫病监测点共检测病原学孵化质控样240份(阳性160份,阴性80份),检出阳性样本105份,阴性样本67份,总符合率为71.67%(172/240),总漏检率为34.38%(55/160),其中强阳性样本漏检率为32.50%(26/80),弱阳性样本漏检率为36.25%(29/80),阴性误检率为16.25%(13/80)。安徽、湖北、湖南、江苏、江西和四川6省血吸虫病监测点对病原学孵化质控样本检出率分别为61.11%、80.00%、77.08%、90.48%、58.33%和59.26%,差异有统计学意义(χ2 = 14.27,P < 0.05)。结论 尼龙绢集卵孵化法现场检测血吸虫病效果显著优于Kato?Katz法,但大多数血吸虫病监测点对尼龙绢孵化法的掌握程度较低,需进一步加强血吸虫病诊断技术培训。

关键词: 血吸虫病;诊断;Kato?Katz法;尼龙绢集卵孵化法;质量控制

CLC Number: