Abstract:

Objective To understand the quality of malaria blood examinations in township?level hospitals，so as to provide the evidence for continuing the malaria blood examinations in the stage of post?malaria elimination. Methods A total of 64 township hospitals were investigated and 640 negative malaria blood slides were scored individually according to 10 indicators in "Malaria Elimination Technical Scheme" in 2013 and 2014. The single and multiple indicators were calculated， and the work of blood examinations and situation of technicians were investigated. The data of malaria blood examinations and patient discovery in township hospitals of Nantong City were collected and analyzedduring the period of 2011-2014. Results Forthe single indicator， 29.5% of the thick blood films did not reach the standard， and 35.8% of thin blood films did not reach the standard. For the multiple indicators， blood slides with more than 4 indicators below the standard（poor quality）accounted for 32.5%. From malaria blood examinations and malaria situation， the number of slides was 194 635 during the period of 2011-2014， and there were no local vivax malaria casesin 4consecutive years from 2011 to 2014， andlocal malaria has been effectively controlled in Nantong City. For health facilities where malaria patients initially presented， the township and village level accounted for 16.3%， and county and higher level accounted for 83.7%. Conclusions The quality of malaria blood examinations in township level hospitals of Nantong City is not high and the microscopic examination has a relatively low efficiency in the discovery of malaria cases. A new model for malaria blood examinations needs to be further explored.

Key words: Malaria； Blood examination； Bloodsmear； Nantong City

摘要： 目的 了解基层乡（镇）级医院疟疾血检质量，为达到消除疟疾标准后持续开展疟疾血检工作提供科学依据。方法 按照《消除疟疾技术方案》中规定的10项指标，2013年和2014年连续2年对南通市64家乡（镇）级医院的640张疟疾检测阴性的血片逐一进行打分，分别计算单一指标和多项指标的达标情况，同时对各医院的血检工作情况、血检人员情况进行调查；收集南通市2011-2014年乡（镇）级医院开展疟疾血检工作和发现疟疾病人情况并进行分析。结果 从单一指标来看，厚血膜血片不达标率平均为29.5%，薄血膜血片不达标率平均为35.8%；从多项指标来看，有4个及以上指标不达标的血片（差血片）占32.5%。从发热病人血检和发病情况来看，全市2011-2014年共血检194 635 人，且自2011年起已经连续4年无发现本地感染的间日疟出现。从所有疟疾病例初诊单位来看，乡（镇）村级医院占16.3%，县级及以上医院占83.7%。结论 南通市乡（镇）级医院疟疾血检工作质量不高，血片镜检在发现疟疾病例中效率较低，需进一步探索基层疟疾血检工作新模式。

关键词: 疟疾；血检；血片；南通市