METHODS: A preliminary evaluation index system was constructed based on literature review, panel discussions and field surveys. Thirty-three experts were selected from 7 provincial disease control and prevention centers in Beijing Municipality, Hebei Province, Shanxi Province, Henan Province, Sichuan Province, Shaanxi Province and Gansu Province where mountain-type zoonotic visceral leishmaniasis was endemic, and two rounds of expert consultations were conducted to screen the indicators. The positive coefficient, degree of concentration, degree of coordination, and authority of the experts were calculated, and the normalized weights of each index were calculated with the analytic hierarchy process.
RESULTS: The response rates of questionnaires during two rounds of expert consultation were both 100.00% (33/33), and the authority coefficients of the experts were 0.86 and 0.88, respectively. The coefficients of coordination among experts on the rationality, importance, and operability of the indicators were 0.392, 0.437, 0.258, and 0.364, 0.335, 0.263, respectively (all P values < 0.05). Following screening, the final evaluation index system included 3 primary indicators, 17 secondary indicators, and 50 tertiary indicators. The normalized weights of primary indicators \"external environment\", \"internal support\" and \"comprehensive control\" were 16.98%, 38.73% and 44.29%, respectively. Among the secondary indicators of the primary indicator \"external environment\", the highest weight was seen for natural environment (66.67%), and among the secondary indicators of the primary indicator \"internal support\", the lowest weight was seen for the scientific research for visceral leishmaniasis control (8.26%), while other indicators had weights of 12.42% to 13.38%. Among the secondary indicators of the primary indicator \"comprehensive control\", the weight was 16.67% for each indicator.
CONCLUSIONS: An evaluation index system has been constructed for the capability of comprehensive control of mountain-type zoonotic visceral leishmaniasis based on the One Health concept. In addition to assessment of the effect of conventional mountain-type zoonotic visceral leishmaniasis control measures, this index system integrates the importance of top-level design, organizational management, and implementation of control measures, and includes indicators related to multi-sectoral cooperation.
[摘要] 目的 基于全健康理念构建犬源型内脏利什曼病 (mountain-type zoonotic visceral leishmaniasis, MT-ZVL) 综合治 理能力评估指标体系, 从全健康的整体视角探索遏制该病疫情回升的切入点, 以促进其控制与消除。方法 在文献分析 基础上, 结合课题组讨论、现场调查等初步构建指标体系。在北京、河北、山西、河南、四川、陕西、甘肃7个MT-ZVL流行 省 (直辖市) 的省级疾病预防控制中心, 选择33名专家开展两轮专家咨询, 对指标进行筛选, 并计算专家积极系数、专家 意见集中程度、专家意见协调程度、专家权威程度, 采用层次分析法计算各指标归一化权重。结果 两轮专家咨询法问 卷回收率均为100.00% (33/33), 专家权威系数分别为0.86和0.88, 指标合理性、重要性、可操作性的专家意见协调系数分 别为0.392、0.437、0.258和0.364、0.335、0.263 (P 均< 0.05)。经过筛选, 最终形成的指标体系包括3个一级指标、17个二 级指标、50个三级指标。“外部环境”、“内部支持”、“综合治理” 3个一级指标归一化权重分别为16.98%、38.73%、44.29%; “外部环境” 的二级指标中, “自然环境” 权重最高 (66.67%); “内部支持” 的二级指标中, “内脏利什曼病防治科学研究” 权 重最低 (8.26%), 其他指标权重在12.42%~13.38%; “综合治理” 的二级指标中, 各指标权重均为16.67%。结论 构建了 基于全健康理念的MT-ZVL综合治理能力评估指标体系。该指标体系在兼顾传统MT-ZVL防治效果评估的同时, 综合考 虑了顶层设计、组织管理和防治措施落实的重要性, 纳入了多部门协作相关指标。.