PDF(Sci-hub)
Abstract：
BACKGROUND: Strong laboratory capacity is essential for detecting and responding to emerging and re-emerging global health threats. We conducted a quantitative laboratory assessment during 2014-2015 in two resource-limited provinces in southern China, Guangxi and Guizhou in order to guide strategies for strengthening core capacities as required by the International Health Regulations (IHR 2005).
METHODS: We selected 28 public health and clinical laboratories from the provincial, prefecture and county levels through a quasi-random sampling approach. The 11-module World Health Organization (WHO) laboratory assessment tool was adapted to the local context in China. At each laboratory, modules were scored 0-100% through a combination of paper surveys, in-person interviews, and visual inspections. We defined module scores as strong (> = 85%), good (70-84%), weak (50-69%), and very weak (< 50%). We estimated overall capacity and compared module scores across the provincial, prefecture, and county levels.
RESULTS: Overall, laboratories in both provinces received strong or good scores for 10 of the 11 modules. These findings were primarily driven by strong and good scores from the two provincial level laboratories; prefecture and county laboratories were strong or good for only 8 and 6 modules, respectively. County laboratories received weak scores in 4 modules. The module, \'Public Health Functions\' (e.g., surveillance and reporting practices) lagged far behind all other modules (mean score = 46%) across all three administrative levels. Findings across the two provinces were similar.
CONCLUSIONS: Laboratories in Guangxi and Guizhou are generally performing well in laboratory capacity as required by IHR. However, we recommend targeted interventions particularly for county-level laboratories, where we identified a number of gaps. Given the importance of surveillance and reporting, addressing gaps in public health functions is likely to have the greatest positive impact for IHR requirements. The quantitative WHO laboratory assessment tool was useful in identifying both comparative strengths and weaknesses. However, prior to future assessments, the tool may need to be aligned with the new WHO IHR monitoring and evaluation framework.
METHODS: We selected 28 public health and clinical laboratories from the provincial, prefecture and county levels through a quasi-random sampling approach. The 11-module World Health Organization (WHO) laboratory assessment tool was adapted to the local context in China. At each laboratory, modules were scored 0-100% through a combination of paper surveys, in-person interviews, and visual inspections. We defined module scores as strong (> = 85%), good (70-84%), weak (50-69%), and very weak (< 50%). We estimated overall capacity and compared module scores across the provincial, prefecture, and county levels.
RESULTS: Overall, laboratories in both provinces received strong or good scores for 10 of the 11 modules. These findings were primarily driven by strong and good scores from the two provincial level laboratories; prefecture and county laboratories were strong or good for only 8 and 6 modules, respectively. County laboratories received weak scores in 4 modules. The module, \'Public Health Functions\' (e.g., surveillance and reporting practices) lagged far behind all other modules (mean score = 46%) across all three administrative levels. Findings across the two provinces were similar.
CONCLUSIONS: Laboratories in Guangxi and Guizhou are generally performing well in laboratory capacity as required by IHR. However, we recommend targeted interventions particularly for county-level laboratories, where we identified a number of gaps. Given the importance of surveillance and reporting, addressing gaps in public health functions is likely to have the greatest positive impact for IHR requirements. The quantitative WHO laboratory assessment tool was useful in identifying both comparative strengths and weaknesses. However, prior to future assessments, the tool may need to be aligned with the new WHO IHR monitoring and evaluation framework.
摘要：
背景：强大的实验室能力对于检测和应对新出现和重新出现的全球健康威胁至关重要。我们在2014-2015年期间对中国南方两个资源有限的省份进行了定量实验室评估，广西和贵州，以便按照《国际卫生条例》(2005年)的要求，指导加强核心能力的战略。
方法：我们从省级公共卫生和临床实验室中选择了28个，地县两级采用准随机抽样的方法。世界卫生组织（WHO）的11个模块实验室评估工具已根据中国当地情况进行了调整。在每个实验室，通过纸质调查的组合，模块得分为0-100%，面对面采访,和视觉检查。我们将模块分数定义为强(>=85%)，良好（70-84%），弱（50-69%），非常弱（<50％）。我们估计了整体容量，并比较了全省的模块分数，县,和县级。
结果：总体而言，这两个省的实验室在11个模块中的10个获得了较高或较好的分数。这些发现主要是由两个省级实验室的强大和良好的分数驱动的;州和县实验室只有8和6个模块的强大或良好，分别。县实验室在4个模块中得分较弱。该模块，“公共卫生职能”(例如，监视和报告实践）在所有三个行政级别中都远远落后于所有其他模块（平均得分=46％）。这两个省的调查结果相似。
结论：广西和贵州的实验室总体上表现良好，符合《国际卫生条例》的要求。然而,我们建议有针对性的干预措施，特别是对县级实验室，我们发现了一些差距。鉴于监测和报告的重要性，解决公共卫生职能的差距可能对《国际卫生条例》的要求产生最大的积极影响。世卫组织实验室定量评估工具有助于确定比较优势和劣势。然而,在未来的评估之前，该工具可能需要与新的世卫组织《国际卫生条例》监测和评估框架保持一致。
方法：我们从省级公共卫生和临床实验室中选择了28个，地县两级采用准随机抽样的方法。世界卫生组织（WHO）的11个模块实验室评估工具已根据中国当地情况进行了调整。在每个实验室，通过纸质调查的组合，模块得分为0-100%，面对面采访,和视觉检查。我们将模块分数定义为强(>=85%)，良好（70-84%），弱（50-69%），非常弱（<50％）。我们估计了整体容量，并比较了全省的模块分数，县,和县级。
结果：总体而言，这两个省的实验室在11个模块中的10个获得了较高或较好的分数。这些发现主要是由两个省级实验室的强大和良好的分数驱动的;州和县实验室只有8和6个模块的强大或良好，分别。县实验室在4个模块中得分较弱。该模块，“公共卫生职能”(例如，监视和报告实践）在所有三个行政级别中都远远落后于所有其他模块（平均得分=46％）。这两个省的调查结果相似。
结论：广西和贵州的实验室总体上表现良好，符合《国际卫生条例》的要求。然而,我们建议有针对性的干预措施，特别是对县级实验室，我们发现了一些差距。鉴于监测和报告的重要性，解决公共卫生职能的差距可能对《国际卫生条例》的要求产生最大的积极影响。世卫组织实验室定量评估工具有助于确定比较优势和劣势。然而,在未来的评估之前，该工具可能需要与新的世卫组织《国际卫生条例》监测和评估框架保持一致。
