OBJECTIVE: To understand the quality of production of blood slides and laboratory personnel\'s ability to microscopically examine Plasmodium at Jiangsu Province clinic inspection stations at all levels, so as to provide the evidence for the construction of malaria diagnostic laboratories and the evaluation of malaria elimination effect.
METHODS: After the reexamination of the negative blood slides of the examination stations of the malaria center in each county (district), the negative blood slides of the outpatient inspection station in the district and all the positive blood slides of the direct report of the network from 2011 to 2017, the staining and cleanliness of the blood smears, microscopic examination results and the coincidence rate of positive blood species were comprehensively analyzed.
RESULTS: A total of 19 109 checked blood samples were examined. The qualified rates of blood preparation, dyeing and cleanliness were 87.5%, 89.3% and 87.6%, respectively. The quality of reexamined blood slides in different years showed statistically significant difference (all P < 0.05), by using chi-square trend test, and there was a trend of increasing year by year. There was a significant difference in the quality of the reexamined blood slides among the different cities with districts (P < 0.05). In addition, there were 1 860 blood samples from 2012 to 2017, and the total coincidence rate was 87.4% and the coincidence rate of positive blood smear examinations was 98.9%. The species coincidence rates of Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale and mixed infection were 95.4%, 33.3%, 56.0%, 76.5% and 9.1%, respectively (P < 0.05). The total coincidence rates of blood smear reexaminations in different years were 85.0%, 90.1%, 86.0%, 85.3%, 90.0% and 87.6% from 2012 to 2017, respectively, and the difference was not statistically significant (P > 0.05).
CONCLUSIONS: The quality of blood slides at the primary clinic inspection stations in Jiangsu Province conforms to the standard established by the provincial malaria reference laboratory; however, the ability of Plasmodium species identification is insufficient and needs to be improved.
[摘要] 目的 了解消除疟疾阶段江苏省发热病人疟原虫血涂片制作质量和实验室人员疟原虫镜检能力, 为各级疟疾 诊断实验室建设和消除疟疾效果评价提供科学依据。方法 对2011–2017年江苏省全部网报疟疾病例血涂片和随机抽 取的县级疟疾中心镜检站已复核阴性血片, 以及辖区内门诊镜检站已检阴性血片进行镜检复核, 从血片制作、染色、清洁 度、镜检结果及虫种符合情况进行综合分析。结果 2011–2017年共抽检复核已检血片19 109张, 血片制作、染色、清洁 度合格率分别为87.5%、89.3%、87.6%, 不同年份血片质量差异有统计学意义 (P 均< 0.05), 并有逐年增高的趋势。不同 设区市血片质量差异有统计学意义 (P < 0.05)。复核2012–2017年网报疟疾病例血片1 860张, 总符合率为87.4%, 阳性 符合率为98.9%。恶性疟、间日疟、三日疟、卵形疟、混合感染虫种符合率分别为95.4%、33.3%、56.0%、76.5%、9.1%, 差异 有统计学意义 (P < 0.05)。2012–2017年不同年份网报疟疾病例血片复核总符合率分别为85.0%、90.1%、86.0%、85.3%、 90.0%、87.6%, 差异无统计学意义 (P > 0.05)。结论 江苏省基层门诊镜检站的血片质量达到省疟疾诊断参比实验室制 定的判定标准, 血片诊断符合率较高, 但虫种鉴别能力有待进一步提高。.