Abstract: Objective To compare the application effects of three methods， namely microscopic examination， antigen detection （RDT） and nucleic acid test （PCR） in malaria detection between municipal and districts/counties centers for disease control and prevention in Shanghai， and analyze the malaria detection ability of the laboratories in Shanghai. Methods The blood smears， whole blood samples， case review confirmation records and case data of malaria cases and suspected cases in Shanghai from 2012 to 2015 were collected by Shanghai Municipal Center for Disease Control and Prevention， and the detection results were analyzed and compared. Results A total of 212 samples with complete data were submitted by all districts （counties） in Shanghai from 2012 to 2015， the samples submitted by Jinshan Districts were the most （41.98%）， and among the first diagnosis hospitals， those submitted by the tertiary hospitals were the most （82.07%）. The submitted samples in the whole year were increased gradually from January to October. All the 212 samples were detected by three methods （the microscopic examination， RDT and PCR） in the laboratory of Shanghai Municipal Center for Disease Control and Prevention， and 167 were tested and confirmed comprehensively as positives， accounting for 78.77%， and 45 were confirmed as negatives， accounting for 21.23%. The samples were detected by the method of microscopy and domestic RDT in the laboratories of the centers for disease control and prevention at district/county level， totally 153 were tested as positives， accounting for 72.17%， 41 were unclassified， accounting for 19.34%， 53 were negative， accounting for 25.00%， and 6 were undetected， accounting for 2.83%. The coincidence of microscopic examination between the report hospitals and the centers for disease control and prevention at district/county level was 78.16%， and the coincidence between centers for disease control and prevention at district/county level and municipal level was 93.20%. The utilization rate of RDT in the laboratory of district/county level was 73.58%. The coincidence of RDT tests between those domestic and imported was 93.59%. Compared with the detection results by municipal center for disease control and prevention， 37 samples were misjudged by the laboratories of district/county level. Almost all （99.37%） of the confirmed malaria cases were imported overseas， including Africa （85.44%）， Asia （13.92%） and America （0.63%）. Conclusion The surveillance after malaria elimination in Shanghai should be carried out by combining with different detection methods and resource integration.

Key words: Malaria； Detection ability； Microscopic examination； RDT； PCR； Imported case； Shanghai City

摘要： 目的 比较疟原虫镜检、抗原快速检测（RDT）和核酸检测（PCR）3种方法在上海市级和区县级疾病预防控制中心（疾控中心）的应用情况，对该市疟疾实验室检测能力进行分析。方法 由上海市疾控中心收集2012-2015年上海市疟疾病例和疑似疟疾病例的血涂片、全血血样、病例复核确认记录单和上海市疟疾病例疫情资料，并对检测结果进行比较分析。结果 2012-2015年，上海市各区县共送检数据完整的样本212份，各区县中以金山区送样量最多（41.98%），报告医院以三级医院送样量最多（82.07%）；1-10月间送检样本量逐渐增多。市疾控中心对212份血样均采用显微镜检、RDT和PCR 3种方法同时进行检测，综合判定疟疾确诊样本共计167份（78.77%），阴性样本45份（21.23%）。区县级实验室使用显微镜检和国产RDT对样本进行检测，判定疟疾阳性样本153份（72.17%），其中阳性未分型41份（19.34%），阴性样本53份（25.00%），未检测6份（2.83%）。报告医院与区县疾控中心镜检符合率为78.16%，区县疾控中心与市疾控中心镜检符合率为93.20%；区县级实验室RDT使用率为73.58%，国产RDT检测和市疾控中心进口RDT检测的符合率为93.59%。以市疾控中心检测结果作为标准，区县级实验室误判37份。99.37％的疟疾确诊病例为境外输入，包括非洲（85.44％）、亚洲（13.92％）和美洲（0.63％）。结论 上海市消除疟疾后的监测工作应结合多种检测方法，整合资源开展。

关键词: 疟疾；检测能力；镜检；RDT；PCR；输入病例；上海市