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目的贵州省级疟疾参比实验室对市(州)级疟疾实验室上送的血涂片和滤纸血样进行复核,评价市(州)级疟疾实验室的检测能力。方法2014-2016年,贵州省疟疾参比实验室通过镜检和巢式PCR分别对市(州)级疟疾实验室上送的血涂片和滤纸血样进行复核,评价上送的血涂片制作质量。以省级疟疾参比实验室镜检结果为标准,分析市(州)级疟疾实验室镜检的疟原虫阳性、阴性和虫种符合情况。分析省级疟疾参比实验室镜检和巢式PCR结果。结果 2014-2016年,市(州)级疟疾实验室共上送至省级疟疾参比实验室血涂片163份,经市(州)级疟疾实验室镜检,阳性84份,阴性79份,滤纸血样159份,上送率分别为100%(163/163)和97.6%(159/163)。血涂片制作、染色、清洁度及综合判定的合格率分别为58.9%(96/163)、75.5%(123/163)、72.4%(118/163)和69.9%(114/163),2016年血涂片制作和综合判定的合格率(71.3%、95.0%)均高于2014年(46.4%、46.4%)和2015年(48.1%、44.4%)(P<0.05)。2014-2016年,省级疟疾参比实验室与市(州)级疟疾实验室血涂片的镜检总符合率分别为67.9%(38/56)、66.7%(18/27)和88.8%(71/80),2016年总符合率高于2014年和2015年,差异有统计学意义(P<0.05);阳性符合率分别为81.3%(26/32)、70.0%(14/20)和96.9%(31/32),3年间差异无统计学意义(P>0.05);虫种符合率分别为46.9%(15/32)、65.0%(13/20)和81.3%(26/32),2014年虫种符合率与2016年比较,差异有统计学意义(P<0.05);阴性符合率分别为95.8%(23/24)、5/7和93.8%(45/48),3年间差异无统计学意义(P>0.05)。省级疟疾参比实验室镜检与巢式PCR检测结果均为阳性且虫种一致的占44.0%(70/159),均为阴性的占48.4%(77/159),结果不一致的占7.6%(12/159)。结论2016年市(州)级疟疾实验室血涂片综合判定合格率和镜检总符合率均高于2014和2015年,说明市(州)级疟疾实验室检测能力有提升。
Objective Guizhou province-level malaria reference laboratory reviews blood smear and filter paper blood samples sent from municipal (state) malaria laboratories to evaluate the detection ability of municipal (state) malaria laboratories. Methods From 2014 to 2016, malaria reference laboratories in Guizhou Province reviewed blood smears and filter paper blood samples sent from municipal (state) malaria laboratories by microscopic examination and nested PCR respectively, and evaluated the blood smear preparation quality. Based on the results of the provincial-level malaria reference laboratory microscopy, the positive and negative malaria parasites of municipal (state) -level malaria laboratory examination were analyzed. Analysis of provincial malaria reference laboratory microscopy and nested PCR results. Results From 2014 to 2016, 163 municipal malaria laboratories were sent to the provincial malaria reference laboratories for blood smears, which were microscopically examined by municipal (state) malaria laboratory with 84 positive and 79 negative , 159 blood samples of filter paper, the sending rate was 100% (163/163) and 97.6% (159/163) respectively. The pass rates of blood smear making, dyeing, cleanliness and comprehensive judgment were 58.9% (96/163), 75.5% (123/163), 72.4% (118/163) and 69.9% (114/163) respectively, 2016 The pass rate of blood smear production and comprehensive judgment (71.3%, 95.0%) was higher than that of 2014 (46.4%, 46.4%) and 2015 (48.1%, 44.4%) (P <0.05). In 2014-2016, the coincidence rates of the blood smears collected from the provincial malaria reference laboratories and the municipal (state) malaria laboratories were 67.9% (38/56), 66.7% (18/27) and 88.8% (71/80). The overall coincidence rate in 2016 was higher than that in 2014 and 2015 (P <0.05). The positive coincidence rates were 81.3% (26/32) and 70.0% (14/20) respectively, And 96.9% (31/32) respectively. There was no significant difference in three years (P> 0.05). The coincidence rates of the worms were 46.9% (15/32), 65.0% (13/20) and 81.3% ), And the coincidence rate of worms in 2014 was statistically different from that in 2016 (P <0.05). The negative coincidence rates were 95.8% (23/24), 5/7 and 93.8% (45/48), respectively There was no significant difference between years (P> 0.05). The provincial malaria reference laboratory microscopy and nested PCR test results were positive and the same bug species accounted for 44.0% (70/159), were negative accounted for 48.4% (77/159), the results were inconsistent accounted for 7.6 % (12/159). Conclusion The overall compliance rates of blood smears and the coincidence rates of microscopic examination in malaria laboratory in 2016 are higher than those in 2014 and 2015, which indicates that the detection ability of municipal (state) malaria laboratories has been improved.