Analysis of diagnostic accordance rate of viral hepatitis B cases in Wenzhou, Zhejiang province, 2006

Objective　The study was conducted to assess the performance and quality of hepatitis B cases report, provide the scientific basis for further improvement of the report system of hepatitis B in medical institutions. Methods　Qualitative interviews and quantitative investigation were conducted. Eighteen medical institutions in 3 counties (cities/districts) with high, moderate and low reported hepatitis B incidence in 2005 were selected to verify the reported hepatitis B cases and the laboratory findings according to the national diagnostic criteria, and 1 doctor in charge of the diagnosis and management of infectious diseases in each of these medical institutions was interviewed about the diagnostic classification and report of hepatitis B cases. Results　A total of 1017 cases were verified, among these cases, 598 were accordant with the national diagnosis criteria of hepatitis B case with the accordance rate of 58.80%. The highest diagnostic accordance rates were observed in county (city) level hospitals, followed by provincial hospitals, and the lowest were in township health centers. The reason of disaccord was that the viral carriers of hepatitis B (81.38%) were diagnosed as hepatitis B cases. The interviewed doctors were unfamiliar with the diagnostic classification and report of hepatitis B cases. Conclusion　The diagnosis accordance rate of hepatitis B was too low, particularly in township health centers. Therefore, it is vital to improve the training on the diagnosis and report of infectious diseases for the clinicians in medical institutions.