黎舒, 陈秋兰, 殷文武, 李昱, 牟笛, 李中杰. 2013-2018年全国布鲁氏菌病诊断现状分析[J]. 疾病监测, 2019, 34(12): 1053-1057. DOI: 10.3784/j.issn.1003-9961.2019.12.005
引用本文: 黎舒, 陈秋兰, 殷文武, 李昱, 牟笛, 李中杰. 2013-2018年全国布鲁氏菌病诊断现状分析[J]. 疾病监测, 2019, 34(12): 1053-1057. DOI: 10.3784/j.issn.1003-9961.2019.12.005
Shu Li, Qiulan Chen, Wenwu Yin, Yu Li, Di Mu, Zhongjie Li. Diagnosis performance of brucellosis in China, 2013–2018[J]. Disease Surveillance, 2019, 34(12): 1053-1057. DOI: 10.3784/j.issn.1003-9961.2019.12.005
Citation: Shu Li, Qiulan Chen, Wenwu Yin, Yu Li, Di Mu, Zhongjie Li. Diagnosis performance of brucellosis in China, 2013–2018[J]. Disease Surveillance, 2019, 34(12): 1053-1057. DOI: 10.3784/j.issn.1003-9961.2019.12.005

2013-2018年全国布鲁氏菌病诊断现状分析

Diagnosis performance of brucellosis in China, 2013–2018

  • 摘要:
    目的掌握我国布鲁氏菌病(布病)诊断现状,为提高医疗卫生机构布病诊断质量提供参考依据。
    方法从中国疾病预防控制信息系统中《疾病监测信息报告管理系统》的个案数据库中提取2013 — 2018年布病相关数据,通过南北方地区、不同医疗卫生机构的发病–诊断间隔和实验室确诊率分析诊断现状。
    结果2013 — 2018年全国累计网络直报布病个案报告卡282 264张,北方报告病例数占全国的95.09%;由医院、疾控机构和基层医疗卫生机构报告的病例分别占50.33%、39.11%和7.73%。 医院报告病例比例逐渐升高,从2013年的35.94%上升到2018年的62.48%。 全国发病–诊断间隔中位数为14 d,6.95%的报告病例的发病–诊断间隔超过90 d,即未在急性期确诊。 从发病–诊断间隔中位数而言,南方小于北方(11 d vs. 14 d),医院和基层医疗卫生机构小于疾控机构和其他医疗卫生机构(9 d、11 d vs. 20 d、25 d)。 全国实验室确诊率为91.61%(北方92.00%、南方84.37%),北方医院、基层医疗卫生机构的实验室确诊率仅为88.76%、87.51%。 全国异地就诊率为47.99%(北方46.95%、南方68.07%)。
    结论2013 — 2018年北方地区布病疫情较重,医疗卫生机构实验室确诊能力仍有不足并存在诊断延误情况,建议重点加强北方地区医疗卫生机构特别是基层医疗机构的布病实验室检测能力建设,提高诊疗可及性。

     

    Abstract:
    ObjectiveTo understand the diagnosis performance of brucellosis in China from 2013 to 2018, and provide reference for the improvement of the diagnosis quality of brucellosis.
    MethodsThe incidence data of brucellosis in China from 2013 to 2018 were collected from the infectious disease information management system of Chinese Center for Disease Control and Prevention(CDC). The diagnosis performance of brucellosis was described by analyzing the intervals between onset and diagnosis of brucellosis and the laboratory confirmation rates in different medical institutions and in northern and southern China.
    ResultsFrom 2013 to 2018, a total of 282 264 brucellosis cases were reported nationwide. Most cases were reported in northern China, accounting for 95.09% of the total. The cases reported by hospitals, CDCs and primary medical units accounted for 50.33%, 39.11% and 7.73% respectively. The proportion of the cases reported by hospitals increased gradually from 35.94% in 2013 to 62.48% in 2018. The median onset-diagnosis interval was 14 d, and 6.95% of the reported cases were diagnosed beyond acute phase (3 months). The median onset-diagnosis interval was shorter in southern China (11 d) than in northern China (14 d), and in hospitals and primary medical units (9 d, 11 d) than in CDCs and other medical units (20 d, 25 d). The overall laboratory confirmation rate was 91.61% (92.00% in northern China and 84.37% in southern China). In northern China, the laboratory confirmation rate was only 88.76% in hospitals and 87.51% in primary medical units. The overall rate of non-local hospital visits was 47.99% (46.95% in northern China and 68.07% in southern China).
    ConclusionIn northern China, the brucellosis epidemic was serious from 2013 to 2018, and the laboratory diagnostic capacity was still inadequate, resulting in some delays in diagnosis. It is suggested to strengthen the building of laboratory diagnostic capacity of the medical institutions in northern China and improve the accessibility of diagnosis and treatment of brucellosis.

     

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