Results of Hubei Provincial malaria diagnostic reference laboratory from 2014 to 2018
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摘要:
目的 分析2014-2018年湖北省疟疾诊断参比实验室样本检测结果，为巩固湖北省疟疾诊断水平提供科学依据。 方法 收集湖北省2014-2018年疟疾网报病例诊断结果和样本，由省级疟疾诊断参比实验室通过镜检和巢式PCR对每份样本进行检测，分析不同年份和不同地区网报阳性结果和虫种符合情况，分析省级镜检和巢式PCR结果。 结果 2014-2018年湖北省共网报疟疾病例674例，省级疟疾诊断参比实验室复核672例，确定疟疾病例633例。总体阳性符合率为94.20%，各年和各地、市(州)阳性符合率均高于80.00%，不同地、市(州)间的阳性符合率差异有统计学意义(χ2 =42.49, P＜0.001)。总体虫种符合率为89.73%，不同年份和不同地、市(州)间虫种符合率差异均有统计学意义(均有P＜0.001)。省级疟疾诊断参比实验室镜检与巢式PCR结果一致率为88.89%，两种方法检测结果一致率在不同虫种间的差异有统计学意义(χ2 =57.37, P＜0.001)。 结论 湖北省2014-2018年疟疾网报病例诊断质量总体较高，对非恶性疟原虫的虫种鉴别能力有待提高。 Abstract:Objective To analyze the results of samples testing of Hubei provincial malaria diagnostic reference laboratory from 2014 to 2018, so as to provide the evidence for improving the malaria diagnostic performance in the province. Methods The samples of reported malaria cases in Hubei were collected by the provincial reference laboratory (PRL) from 2014 to 2018. The microscopy and nested polymerase chain reaction (nested PCR) were performed to confirm the infection of plasmodium species of each case. The agreement rate of diagnosis of malaria and plasmodium species among different years and different regions were calculated. The microscopic and nested PCR results of PRL were analyzed as well. Results A total of 674 malaria cases were reported in Hubei Province from 2014 to 2018. Among the 672 samples which were re-examined by PRL, 633 cases were confirmed plasmodium infections. The total positive coincidence rate was 94.20%. The positive coincidence rate of each year and each district were higher than 80.00%, and there were differences among the 16 districts (χ2 =42.49, P < 0.001). The total species coincidence rate was 89.73%. The species diagnostic coincidence rates among different years and different districts existed differences (all P < 0.001). The consistency rate between microscopic and nested PCR results in the PRL was 88.89%, and there were differences among the different species (χ2 =57.37, P < 0.001). Conclusions From 2014 to 2018, the malaria diagnostic quality of medical technicians is generally high in Hubei Province. However, the ability to identify non-falciparum parasites remains to be improved. -
Key words:
- Malaria /
- Diagnosis /
- Elimination /
- Hubei province
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表 1 2014-2018年湖北省网报疟疾病例样本收集和复核结果
Table 1. Sample collection and confirmative classification of reported malaria cases of Hubei Province from China information system for disease control and prevention from 2014 to 2018
年份(年) 网报病例数(例) 复核数(例) 复核率(%) 确诊阳性数(例) 阳性符合率(%) 虫种符合数(例) 虫种符合率(%) 2014 149 149 100.00 140 93.96 130 92.86 2015 124 124 100.00 120 96.77 113 94.17 2016 157 157 100.00 151 96.18 130 86.09 2017 109 108 99.08 97 89.81 77 79.38 2018 135 134 99.26 125 93.28 118 94.40 合计 674 672 99.70 633 94.20 568 89.73 
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表 2 2014-2018年湖北省网报疟疾病例复核虫种结果
Table 2. Confirmed plasmodium species results of reported malaria cases of Hubei Province from China information system for disease control and prevention from 2014 to 2018
年份(年) 恶性疟原虫(例) 间日疟原虫(例) 卵形疟原虫(例) 三日疟原虫(例) 混合感染(例) 阴性(例) 合计(例) 2014 105 21 11 3 0 9 149 2015 93 10 12 4 1 4 124 2016 103 22 21 3 2 6 157 2017 50 16 24 7 0 11 108 2018 92 17 16 0 0 9 134 合计 443 86 84 17 3 39 672
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表 3 2014-2018年湖北省17个地市(州)诊断结果与省级复核结果比较
Table 3. Coincidence rate for malaria diagnosis between municipal level and provincial level laboratory from 2014 to 2018
地(市、州) 复核病例数(例) 确诊病例数(例) 阳性符合率(%) 虫种符合数(例) 虫种符合率(%) 武汉市 225 223 99.11 222 99.55 宜昌市 100 94 94.00 75 79.79 襄阳市 37 36 97.30 34 94.44 黄石市 47 40 85.11 33 82.50 十堰市 34 30 88.24 26 86.67 鄂州市 5 4 80.00 4 100.00 荆门市 22 21 95.45 17 80.95 孝感市 31 31 100.00 26 83.87 荆州市 26 26 100.00 24 92.31 黄冈市 52 44 84.62 36 81.82 咸宁市 12 12 100.00 11 91.67 随州市 31 29 93.55 19 65.52 恩施州 25 21 84.00 20 95.24 仙桃市 11 10 90.91 9 90.00 潜江市 11 9 81.82 9 100.00 天门市 3 3 100.00 3 100.00 神农架 0 0 - - - 合计 672 633 94.20 568 89.73
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表 4 2014-2018年湖北省疟疾诊断参比实验室镜检与巢式PCR检测结果
Table 4. Results of microscopy and nested PCR in the malaria reference laboratory of Hubei Province from 2014 to 2018
方法 虫种 镜检 合计 恶性疟原虫 间日疟原虫 三日疟原虫 卵形疟原虫 混合感染 阴性 巢式PCR 恶性疟原虫 396 1 1 0 0 24 422 间日疟原虫 1 70 0 6 1 2 80 三日疟原虫 0 1 13 4 0 0 18 卵形疟原虫 0 12 1 73 0 2 88 混合感染 1 0 0 2 0 0 3 阴性 14 1 0 0 0 40 55 合计 412 85 15 85 1 68 666
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