2017年江苏省疟疾诊断参比实验室样本检测结果分析
|
摘要
目的分析2017年江苏省疟疾诊断参比实验室样本检测结果,为巩固江苏省疟疾诊断水平提供科学依据。方法由江苏省疟疾诊断参比实验室收集2017年疟疾网报病例诊断结果和样本;对每份病例样本分别采用镜检、核酸检测复核和疟疾快速诊断试纸条(RDT)检测;比较分析不同地区和不同疟原虫虫种样本检测结果符合情况。结果 2017年江苏省共有疟疾网报病例242例,经复核确定疟疾病例共239例,其中恶性疟163例、间日疟21例、三日疟11例、卵形疟43例、恶性疟和卵形疟原虫混合感染1例。13个设区市疟疾网报病例的诊断符合率均>80%,总符合率为88.8%;恶性疟原虫、间日疟原虫、三日疟原虫、卵形疟原虫检测符合率分别为98.8%、57.1%、63.6%、81.4%,RDT对4种疟原虫感染检出率分别为95.7%、85.0%、63.6%、79.1%。结论 2017年江苏省疟疾网报病例诊断质量总体较高,对非恶性疟人体疟原虫的虫种鉴别能力有待提高,RDT对非恶性疟人体疟原虫感染检测效果不理想。在当前消除疟疾阶段,应加强和保持各部门的疟疾诊断能力。
Objective To analyze the results of samples testing of Jiangsu Provincial Malaria Diagnostic Reference Laboratory in 2017, so as to provide the evidence for improving the malaria diagnostic performance in this province. Methods The samples of reported malaria cases in Jiangsu were collected by the provincial reference laboratory(PRL) in 2017. The microscopy and nucleic acid test were performed to confirm the infection of Plasmodium species of each case, while Plasmodium antigen tests(rapid diagnostic test, RDT) were performed as well. The detection results were analyzed among different areas and different species. Results Totally 242 malaria cases were reported and the samples were collected by PRL in 2017. A total of 239 cases were confirmed Plasmodium infections, including 163 cases of Plasmodium falciparum infection, 21 cases of P vivax infection, 11 cases of P. malariae infection, 43 cases of P. ovale infection, and 1 case of P. faliparum and P. ovale mixed-infection. The diagnostic coincience rates of reported malaria case in 13 prefectures with districts were all > 80%, and the total coincidence rate was 88.8%. The species diagnostic coincidence rates of P. falparum, P. vivax, P. malariae, and P. ovale were98.8%, 57.% 63.6%, and 81.4% respectively, and the detection rates by RDT to those four species infections were 95.7%,85.% 63.6% and 79.1% respectively. Conclusions In 2017, the malaria diagnostic quality of medical technicians is generally high in Jiangsu Province. However, the diagnostic capacity is slightly different among different regions, and the ability to identify non-P. falciparum parasites remains to be improved. RDT is not ideal for the detection of non-P. falciparum infection. In the current stage of malaria elimination, the malaria diagnostic capacity of technicians in all the sectors should be strengthened and maintained.
Objective To analyze the results of samples testing of Jiangsu Provincial Malaria Diagnostic Reference Laboratory in 2017, so as to provide the evidence for improving the malaria diagnostic performance in this province. Methods The samples of reported malaria cases in Jiangsu were collected by the provincial reference laboratory(PRL) in 2017. The microscopy and nucleic acid test were performed to confirm the infection of Plasmodium species of each case, while Plasmodium antigen tests(rapid diagnostic test, RDT) were performed as well. The detection results were analyzed among different areas and different species. Results Totally 242 malaria cases were reported and the samples were collected by PRL in 2017. A total of 239 cases were confirmed Plasmodium infections, including 163 cases of Plasmodium falciparum infection, 21 cases of P vivax infection, 11 cases of P. malariae infection, 43 cases of P. ovale infection, and 1 case of P. faliparum and P. ovale mixed-infection. The diagnostic coincience rates of reported malaria case in 13 prefectures with districts were all > 80%, and the total coincidence rate was 88.8%. The species diagnostic coincidence rates of P. falparum, P. vivax, P. malariae, and P. ovale were98.8%, 57.% 63.6%, and 81.4% respectively, and the detection rates by RDT to those four species infections were 95.7%,85.% 63.6% and 79.1% respectively. Conclusions In 2017, the malaria diagnostic quality of medical technicians is generally high in Jiangsu Province. However, the diagnostic capacity is slightly different among different regions, and the ability to identify non-P. falciparum parasites remains to be improved. RDT is not ideal for the detection of non-P. falciparum infection. In the current stage of malaria elimination, the malaria diagnostic capacity of technicians in all the sectors should be strengthened and maintained.
引文
[1]WHO.World Malaria Report 2018[R].Geneva:World Health Organization,2018:1-3.
[2]Cao Y,Wang W,Liu Y,et al.The increasing importance of Plasmodium ovale and Plasmodium malariae in a malaria elimination setting:an observational study of imported cases in Jiangsu Province,China,2011-2014[J].Malar J,2016,15:459.
[3]Liu Y,Hsiang MS,Zhou H,et al.Malaria in overseas labourers returning to China:an analysis of imported malaria in Jiangsu Province,2001-2011[J].Malar J,2014,13:29.
[4]Liu Y,Sturrock HJW,Yang H,et al.The challenge of imported malaria to eliminating countries[J].Lancet Infect Dis,2017,17(2):141.
[5]顾亚萍,朱国鼎,张超,等.2011-2017江苏省疟疾镜检工作质量分析[J].中国血吸虫病防治杂志,2018,30(4):369-373.
[6]唐建霞,徐岁,刘耀宝,等.疟疾生物样本库的构建与应用[J].中国血吸虫病防治杂志,2018,30(4):455-459.
[7]王伟明,周华云,曹园园,等.2010-2016年江苏省发热病人血检结果分析[J].中国血吸虫病防治杂志,2018,30(4):374-377
[8]中华人民共和国国家卫生和计划生育委员会.疟疾的诊断(WS259-2015)[S].北京:中国标准出版社,2015:3-4.
[9]Wang B,Han SS,Cho C,et al.Comparison of microscopy,nested-PCR,and Real-Time-PCR assays using high-throughput screening of pooled samples for diagnosis of malaria in asymptomatic carriers from areas of endemicity in Myanmar[J].J Clin Microbiol,2014,52(6):1838-1845.
[10]周华云,曹俊,朱国鼎,等.江苏省消除疟疾历程[J].中国血吸虫病防治杂志,2018,30(4):364-368.
[11]周华云,王伟明,朱国鼎,等.2016年江苏省疟疾疫情流行病学分析[J].中国血吸虫病防治杂志,2018,30(1):32-36.
[12]曹园园,王伟明,周华云,等.江苏省2014-2016年境外输入性疟疾病例诊断情况分析[J].中华流行病学杂志,2018,39(2):218-221.
[13]李菊林,朱国鼎,周华云,等.江苏省消除疟疾阶段媒介监测结果分析[J].中国血吸虫病防治杂志,2018,30(4):390-395.
[14]Landier J,Parker DM,Thu AM,et al.The role of early detection and treatment in malaria elimination[J].Malar J,2016,15:363.
[15]Ding G,Zhu G,Cao C,et al.The challenge of maintaining microscopist capacity at basic levels for malaria elimination in Jiangsu Province,China[J].BMC Public Health,2018,18(1):489.
[16]Mukkala AN,Kwan J,Lau R,et al.An update on malaria rapid diagnostic tests[J].Curr Infect Dis Rep,2018,20(12):49.
[17]金嘉杰,王伟明,曹园园,等.江苏省基层专业技术人员疟疾快速诊断试纸条相关知识态度行为调查[J].中国血吸虫病防治杂志,2018,30(4):378-382.
[18]金嘉杰,王伟明,曹园园,等.江苏省基层医疗卫生机构疟疾快速诊断试纸应用现状[J].中华预防医学杂志,2018,52(7):734-737.
[19]Heutmekers M,Gillet P,Maltha J,et al.Evaluation of the rapid diagnostic test CareStart pLDH Malaria(Pf-pLDH/pan-pLDH)for the diagnosis of malaria in a reference setting[J].Malar J,2012,11:204.
[20]Maltha J,Gillet P,Bottieau E,et al.Evaluation of a rapid diagnostic test(CareStart?Malaria HRP-2/pLDH(Pf/pan)Combo Test)for the diagnosis of malaria in a reference setting[J].Malar J,2010,9:171.
[21]唐凤,唐建霞,陆凤,等.万孚疟原虫检测试剂盒检测卵形疟原虫效果评价及影响因素分析[J].中国血吸虫病防治杂志,2016,28(2):146-150.
[22]曹俊,周水森,周华云,等.中国疟疾从控制走向消除--消除阶段的目标策略和措施[J].中国血吸虫病防治杂志,2013,25(5):439-443.
[2]Cao Y,Wang W,Liu Y,et al.The increasing importance of Plasmodium ovale and Plasmodium malariae in a malaria elimination setting:an observational study of imported cases in Jiangsu Province,China,2011-2014[J].Malar J,2016,15:459.
[3]Liu Y,Hsiang MS,Zhou H,et al.Malaria in overseas labourers returning to China:an analysis of imported malaria in Jiangsu Province,2001-2011[J].Malar J,2014,13:29.
[4]Liu Y,Sturrock HJW,Yang H,et al.The challenge of imported malaria to eliminating countries[J].Lancet Infect Dis,2017,17(2):141.
[5]顾亚萍,朱国鼎,张超,等.2011-2017江苏省疟疾镜检工作质量分析[J].中国血吸虫病防治杂志,2018,30(4):369-373.
[6]唐建霞,徐岁,刘耀宝,等.疟疾生物样本库的构建与应用[J].中国血吸虫病防治杂志,2018,30(4):455-459.
[7]王伟明,周华云,曹园园,等.2010-2016年江苏省发热病人血检结果分析[J].中国血吸虫病防治杂志,2018,30(4):374-377
[8]中华人民共和国国家卫生和计划生育委员会.疟疾的诊断(WS259-2015)[S].北京:中国标准出版社,2015:3-4.
[9]Wang B,Han SS,Cho C,et al.Comparison of microscopy,nested-PCR,and Real-Time-PCR assays using high-throughput screening of pooled samples for diagnosis of malaria in asymptomatic carriers from areas of endemicity in Myanmar[J].J Clin Microbiol,2014,52(6):1838-1845.
[10]周华云,曹俊,朱国鼎,等.江苏省消除疟疾历程[J].中国血吸虫病防治杂志,2018,30(4):364-368.
[11]周华云,王伟明,朱国鼎,等.2016年江苏省疟疾疫情流行病学分析[J].中国血吸虫病防治杂志,2018,30(1):32-36.
[12]曹园园,王伟明,周华云,等.江苏省2014-2016年境外输入性疟疾病例诊断情况分析[J].中华流行病学杂志,2018,39(2):218-221.
[13]李菊林,朱国鼎,周华云,等.江苏省消除疟疾阶段媒介监测结果分析[J].中国血吸虫病防治杂志,2018,30(4):390-395.
[14]Landier J,Parker DM,Thu AM,et al.The role of early detection and treatment in malaria elimination[J].Malar J,2016,15:363.
[15]Ding G,Zhu G,Cao C,et al.The challenge of maintaining microscopist capacity at basic levels for malaria elimination in Jiangsu Province,China[J].BMC Public Health,2018,18(1):489.
[16]Mukkala AN,Kwan J,Lau R,et al.An update on malaria rapid diagnostic tests[J].Curr Infect Dis Rep,2018,20(12):49.
[17]金嘉杰,王伟明,曹园园,等.江苏省基层专业技术人员疟疾快速诊断试纸条相关知识态度行为调查[J].中国血吸虫病防治杂志,2018,30(4):378-382.
[18]金嘉杰,王伟明,曹园园,等.江苏省基层医疗卫生机构疟疾快速诊断试纸应用现状[J].中华预防医学杂志,2018,52(7):734-737.
[19]Heutmekers M,Gillet P,Maltha J,et al.Evaluation of the rapid diagnostic test CareStart pLDH Malaria(Pf-pLDH/pan-pLDH)for the diagnosis of malaria in a reference setting[J].Malar J,2012,11:204.
[20]Maltha J,Gillet P,Bottieau E,et al.Evaluation of a rapid diagnostic test(CareStart?Malaria HRP-2/pLDH(Pf/pan)Combo Test)for the diagnosis of malaria in a reference setting[J].Malar J,2010,9:171.
[21]唐凤,唐建霞,陆凤,等.万孚疟原虫检测试剂盒检测卵形疟原虫效果评价及影响因素分析[J].中国血吸虫病防治杂志,2016,28(2):146-150.
[22]曹俊,周水森,周华云,等.中国疟疾从控制走向消除--消除阶段的目标策略和措施[J].中国血吸虫病防治杂志,2013,25(5):439-443.