罗敏, 易瑶, 张应涛, 何凡, 陈熙, 康敏, 宋铁, 邓爱萍. 登革热诊断标准(WS 216-2018)跟踪评价[J]. 疾病监测, 2021, 36(1): 92-97. DOI: 10.3784/jbjc.202007160246
引用本文: 罗敏, 易瑶, 张应涛, 何凡, 陈熙, 康敏, 宋铁, 邓爱萍. 登革热诊断标准(WS 216-2018)跟踪评价[J]. 疾病监测, 2021, 36(1): 92-97. DOI: 10.3784/jbjc.202007160246
Luo Min, Yi Yao, Zhang Yingtao, He Fan, Chen Xi, Kang Min, Song Tie, Deng Aiping. Evaluation of implementation of Diagnostic Criteria of Dengue Fever (WS 216-2018)[J]. Disease Surveillance, 2021, 36(1): 92-97. DOI: 10.3784/jbjc.202007160246
Citation: Luo Min, Yi Yao, Zhang Yingtao, He Fan, Chen Xi, Kang Min, Song Tie, Deng Aiping. Evaluation of implementation of Diagnostic Criteria of Dengue Fever (WS 216-2018)[J]. Disease Surveillance, 2021, 36(1): 92-97. DOI: 10.3784/jbjc.202007160246

登革热诊断标准(WS 216-2018)跟踪评价

Evaluation of implementation of Diagnostic Criteria of Dengue Fever (WS 216-2018)

  • 摘要:
      目的  了解《登革热诊断标准(WS 216-2018)》(《标准》)的实施情况、效果及其使用过程中遇到的问题,为《标准》修订和促进实施提供参考。
      方法  选择广东省、浙江省、重庆市的综合医院、社区卫生服务中心、疾病预防控制中心(CDC)、海关检疫部门的人员进行问卷调查和现场调研,采用EpiData 3.1软件建立数据库,用SPSS 22.0软件进行统计分析,采用χ2检验、方差分析和Kruskal-Wallis H检验比较组间差异。
      结果  共调查61家机构,共收回637份问卷,其中广东省443份(69.54%)、重庆市102份(16.01%)、浙江省92份(14.44%)。 所属机构类型以综合医院(86.66%)为主,机构归属以区/县级(56.51%)为主。 研究对象对《标准》的总掌握率为67.66%,其中广东省的掌握率(69.31%)高于重庆市(66.36%)和浙江省(61.14%),综合医院的掌握率(67.02%)总体低于社区卫生服务中心(69.05%)和CDC(74.43%)。 既往通过培训宣贯的途径知晓《标准》的比例最高,占76.61%。每次均使用该《标准》的临床医生占25.84%,28.50%经常使用,33.63%偶尔使用,12.03%几乎不使用。 73.45%和64.25%的临床医生能分别正确回答发病5 d内和7 d后的疑似病例应开展的检测项目。 仅42.48%的临床医生能全部正确回答所在医院开设的具体登革热诊断检测项目。 96.55%的综合医院可以开展登革病毒NS1抗原筛查,所调查的广东省社区卫生服务中心中有87.50%可开展此筛查,浙江省2家社区卫生服务中心均可开展,重庆市的社区卫生服务中心均不能开展。 调查的重庆市和浙江省3家CDC均可开展登革病毒核酸检测,调查的广东省的CDC中有58.33%可开展此检测,非珠三角地区的区级CDC尚不能开展。《标准》在实施过程中,与相关规范性文件保持了较好的一致性。
      结论  登革热诊断相关医务工作者对《标准》的掌握率和使用率较低,《标准》的培训宣贯工作需进一步加强。

     

    Abstract:
      Objective  To evaluate the implementation of Diagnostic Criteria of Dengue Fever (WS 216-2018) and provide reference for the revision and better application of the criteria.
      Methods  Using stratified random sampling, general hospitals, community health service centers, centers for disease control and prevention (CDCs) and customs in Guangdong, Zhejiang and Chongqing were selected to conduct questionnaire survey and field investigation. EpiData 3.1 was used to establish a database, and SPSS 22.0 was used for statistical analysis. Inter group differences were compared with χ2 test, analysis of variance and Kruskal-Wallis H test.
      Results  A total of 61 medical institutions were surveyed, and 637 questionnaires were collected, in which 443 were from Guangdong (69.54%), 102 from Chongqing (16.01%) and 92 from Zhejiang (14.44%). The institutions were mainly general hospitals (86.66%) and the medical and health institutions at district or county level accounted for 56.51%. The total mastery rate of the criteria was 67.66%. The mastery rate in Guangdong (69.31%) was higher than that in Chongqing (66.36%) and Zhejiang (61.14%), and the mastery rate in general hospitals (67.02%) was lower than that in community health service centers (69.05%) and CDCs (74.43%). The awareness rate of the criteria through training was highest, reaching 76.61%. In clinicians surveyed, 25.84% used the criteria all the time, 28.50% often used it, 33.63% used it occasionally and 12.03% never used it. There were 73.45% and 64.25% of clinicians who could answer the questions about the tests to be conducted for suspected cases within five days and within seven days after onset. Only 42.48% of clinicians knew the dengue diagnostic tests to be provided in their hospitals. 96.55% of general hospitals could provide NS1 screening for dengue virus antigen. In the community health service centers surveyed, 87.50% in Guangdong could carry out NS1 screening, 2 in Zhejiang could provide NS1 screening, and all in Chongqing could not provide NS1 screening. Three CDCs surveyed in Chongqing and Zhejiang were all able to conduct nucleic acid testing for dengue virus. Among the 12 CDCs surveyed in Guangdong, 58.33% (7/12) were allowed to conduct nucleic acid testing, and the CDCs in non-Pearl River Delta area could not provide nucleic acid testing. In the process of implementation of the criteria, a good consistency was found in relevant regulation documents.
      Conclusion  The mastery rate and use rate of the criteria were low in clinicians, it is necessary to further strengthen the training for the use promotion of the criteria.

     

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