我国血吸虫病防治机构能力建设现状调查

doi:10.16250/j.32.1374.2023208

摘要/Abstract

摘要： 目的　了解我国血吸虫病流行省（直辖市、自治区）血吸虫病防治机构能力建设现状。方法　2023年5—6月，通过专家研讨及现场访谈、实地走访等方式了解各类血吸虫病防治机构职责任务和建设要求，设计血吸虫病防治能力维持和巩固专题调查问卷。采用问卷星APP对我国承担血吸虫病防治和监测任务的县级、市级及省级卫生机构开展线上问卷调查，分析我国血吸虫病防治机构分布、血吸虫病防治任务承担机构、部门和员工数量及血吸虫病防治科研转化情况；以通过中国合格评定国家认可委员会（China National Accreditation Service for Conformity Assessment, CNAS）认可为实验室有能力开展相应检测工作，分析血吸虫病防治机构检测能力水平。结果　累计收到我国12个血吸虫病流行省（直辖市、自治区）的486家血吸虫病防治机构的有效问卷，其中2.5%（12/486）为省级机构、15.8%（77/486）为市级机构、81.7%（397/486）为县级机构；77.4%（376/486）为疾病预防控制中心或公共卫生中心，21.0%（102/486）为血吸虫病、地方病或寄生虫病防治专业机构，1.6%（8/486）为医院、卫生院或其他。486家血吸虫病防治机构共有在职员工37 713人，其中血吸虫病防治相关员工5 675人。省、市、县级机构血吸虫病防治相关员工数占机构在职总人数的比例分别为5.9%（231/3 897）、5.5%（566/10 134）和20.6%（4 878/23 682）。累计有专职血吸虫病防治员工3 826名，其中年龄≤ 40、41 ~ 50岁及> 50岁员工比例分别为30.5%（1 166/3 826）、34.6%（1 324/3 826）和34.9%（1 336/3 826）；血吸虫病防治工作年限> 25年专职员工占41.0%（1 571/3 826）；初、中级职称分别占35.5%（1 358/3 826）和33.7%（1 290/3 826），18.6%（712/3 826）的血吸虫病防治专职员工不具有专业技术职称。血吸虫病防治机构最核心的3项血吸虫病防治工作任务分别为钉螺控制（26.3%，374/1 420）、疫情监测与管理（25.4%，361/1 420）及健康教育（18.8%，267/1 420）。各级血吸虫病防治机构具备的血吸虫病检测技术中，改良加藤厚涂片法、尼龙绢袋集卵孵化法及间接红细胞凝集试验（indirect hemagglutination test，IHA）占比较高。具备酶联免疫吸附试验（enzyme⁃linked immunosorbent assay，ELISA）、胶体染料试纸条法（dipstick dye immunoassay，DDIA）、金标免疫渗滤试验（dot immunogold filtration assay，DIGFA）、环介导等温扩增技术（loop⁃mediated isothermal amplification，LAMP）和聚合酶链式反应（polymerase chain reaction，PCR）等检测技术能力或实验条件的实验室比例均< 50%。2018—2022年，我国血吸虫病防治机构累计承担血吸虫病防治科研项目211项，总经费1 859.6万元；累计发表论文619篇；参与制定血吸虫病防治相关标准13项；申请相关专利113项，获批101项；成果转化4项。结论　我国血吸虫病防治机构中，独立血吸虫病防治专业机构比例较低、实验室检测能力有待提高、员工年龄结构较老化且职称构成偏低。应加大血吸虫病防治投入和工作力度，加强血吸虫病防治机构能力建设和人才培养，为高质量开展血吸虫病消除工作提供有力支撑。

关键词: 血吸虫病, 消除, 能力建设, 现状调查, 中国

Abstract: [Abstract]　Objective　To understand the current status of capacity building in schistosomiasis control institutes in schistosomiasis⁃endemic provinces (municipality, autonomous region) of China. Methods　The responsibilities and construction requirements of various schistosomiasis control institutions were surveyed by expert discussions, and field interviews and visits during the period between May and June, 2023, and the questionnaire for capacity maintenance and consolidation in schistosomiasis control institutions was designed. An online questionnaire survey was conducted in county⁃, municipal⁃, and provincial⁃level institutions that undertook schistosomiasis control and surveillance activities through the Wenjuanxing program. The distribution of schistosomiasis control institutions, the status of institutions, departments and staff undertaking schistosomiasis control activities and the translation of scientific researches on schistosomiasis control in China were analyzed. The laboratories accredited by China National Accreditation Service for Conformity Assessment (CNAS) were considered to be capable for testing associated with schistosomiasis control, and the testing capability of schistosomiasis control institutions was analyzed. Results　A total of 486 valid questionnaires were recovered from 486 schistosomiasis control institutions in 12 endemic provinces (municipality, autonomous region) of China, including 12 provincial⁃level institutions (2.5%), 77 municipal⁃level institutions (15.8%) and 397 county⁃level institutions (81.7%). Of all schistosomiasis control institutions, 376 (77.4%) were centers for disease control and prevention or public health centers, 102 (21.0%) were institutions for schistosomiasis, endemic disease and parasitic disease control, and 8 (1.6%) were hospitals, healthcare centers or others. There were 37 713 active employees in the 486 schistosomiasis control institutions, including 5 675 employees related to schistosomiasis control, and the proportions of employees associated with schistosomiasis control among all active employees were 5.9% (231/3 897), 5.5% (566/10 134), and 20.6% (4 878/23 682) in provincial⁃, municipal⁃, and county⁃level institutions, respectively. There were 3 826 full⁃time employees working in schistosomiasis control activities, with 30.5% (1 166/3 826), 34.6% (1 324) and 34.9% (1 336/3 826) at ages of 40 years and below, 41 to 50 years and over 50 years, and there were 1 571 (41.0%) full⁃time schistosomiasis control employees with duration of schistosomiasis control activities for over 25 years, and 1 358 (35.5%) employees with junior professional titles and 1 290 with intermediate professional titles (35.5%), while 712 (18.6%) full⁃time employees working in schistosomiasis control activities had no professional titles. The three core schistosomiasis control activities included snail control (26.3%, 374/1 420), epidemics surveillance and management (25.4%, 361/1 420) and health education (18.8%, 267/1 420) in schistosomiasis control institutions. The Kato⁃Katz method, miracidium hatching test with nylon gauzes, and indirect haemagglutination assay (IHA) were the most commonly used techniques for detection of schistosomiasis, and there were less than 50% laboratories that had capabilities or experimental conditions for performing enzyme⁃linked immunosorbent assay (ELISA), dipstick dye immunoassay (DDIA), dot immunogold filtration assay (DIGFA), loop⁃mediated isothermal amplification (LAMP) and polymerase chain reaction (PCR) assays. During the period from 2018 to 2022, schistosomiasis control institutions had undertaken a total of 211 research projects for schistosomiasis control, with a total funding of 18.596 million RMB, published 619 articles, participated in formulation of 13 schistosomiasis control⁃related criteria, and applied for 113 schistosomiasis control⁃related patents, including 101 that were granted, and commercialized 4 scientific research outcomes. Conclusions　The proportion of independent specialized schistosomiasis control institutions is low in schistosomiasis control institutions in China, which suffers from problems of unsatisfactory laboratory testing capabilities, aging of staff and a high proportion of low⁃level professional titles. More investment into and intensified schistosomiasis control activities and improved capability building and talent cultivation in schistosomiasis control institutions are recommended to provide a powerful support for high⁃quality elimination of schistosomiasis in China.

Key words: Schistosomiasis, Elimination, Capacity building, Cross?sectional study, China

中图分类号:

R532.21

何君逸, 李仕祯, 邓王平, 曹淳力, 李石柱, 许静. 我国血吸虫病防治机构能力建设现状调查 [J]. 中国血吸虫病防治杂志, 2024, 36(1): 67-73.

HE Junyi, LI Shizhen, DENG Wangping, CAO Chunli, LI Shizhu, XU Jing. Capacity building in schistosomiasis control institutions in China: a cross⁃sectional study [J]. Chinese Journal of Schistosomiasis Control, 2024, 36(1): 67-73.

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我国血吸虫病防治机构能力建设现状调查

Capacity building in schistosomiasis control institutions in China: a cross⁃sectional study

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