| 刘巧,刘民,刘珏.我国疟疾消除后阶段输入风险评估指标体系的构建[J].中华流行病学杂志,2023,44(1):67-73 |
| 我国疟疾消除后阶段输入风险评估指标体系的构建 |
| Construction of an indicator system for risk assessment on imported malaria during post-elimination period in China |
| 收稿日期:2022-08-15 出版日期:2023-01-14 |
| DOI：10.3760/cma.j.cn112338-20220815-00713 |
| 中文关键词: 输入性疟疾 风险评估 指标体系 德尔菲法 |
| 英文关键词: Imported malaria Risk assessment Indicator system Delphi method |
| 基金项目:国家自然科学基金（72122001）；科技部国家科技援助项目（KY202101004） |
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| 中文摘要: |
| 目的 构建我国疟疾消除后阶段输入风险评估指标体系，为科学评估疟疾输入风险提供参考工具。方法 通过文献综述初步建立疟疾输入风险评估指标体系。选择国内18名疟疾防治专家，采用德尔菲法对指标体系展开2轮专家咨询，请专家对每项指标的重要性、可操作性、熟悉程度和判断依据进行打分，并计算专家积极系数、权威系数、意见协调系数，筛选指标后计算各指标权重。分别采用克朗巴哈α系数，权威系数和因子分析评价指标体系内在信度、内容效度和结构效度。结果 13名专家完成2轮咨询，最终构建包含3个一级指标、6个二级指标和44个三级指标的疟疾输入风险评估指标体系。2轮咨询专家积极系数分别为72%（13/18）和100%（13/13）。对于各项指标重要性评分和可操作性评分的Kendall协调系数值分别为0.22和0.25，均具有显著性。指标体系重要性评分、可操作性评分、熟悉程度评分和判断依据评分的克朗巴哈α系数值分别为0.938、0.945、0.983、和0.962。各二级指标条目下归一化权重值居第1位的三级指标分别为境外感染风险中的入境人员是否严格执行防护措施（0.048 1）、虫媒特征中的当地媒介能量（0.019 8）、自然因素特征中的当地海拔（0.028 5）、外部暴露风险中的来源国抗疟药物可及性（0.034 2）、境内传播风险中的当地与来源国的地理位置关系（0.050 1）和内部防控能力中的多部门联合防控机制（0.044 6）。结论 所构建的疟疾输入风险评估指标体系可为消除疟疾后防止其输入后再传播、巩固疟疾消除成果提供参考工具。 |
| 英文摘要: |
| Objective To establish an indicator system for risk assessment on imported malaria and provide a reference tool for the assessment of risk of imported malaria during post-elimination period in China. Methods A preliminary risk assessment indicator system for imported malaria was established through a literature review. Eighteen malaria control experts in China were invited to conduct two rounds of consultation on the indicator system using Delphi method, and experts were asked to score the importance, operability, familiarity and judgment basis of each indicator, and the active coefficient, authority coefficient and coordination coefficient of the experts were calculated. Cronbach's coefficient α, expert authority coefficient and factor analysis were used to evaluate the intrinsic reliability, content validity and structural validity of the indicator system, respectively. Results Finally, 13 experts completed 2 rounds of consultation for the construction of an imported malaria risk assessment indicator system consisting of 3 primary indicators, 6 second level indicators and 44 third level indicators. The active coefficients of the experts were 72% (13/18) and 100% (13/13) respectively in the 2 rounds of consultation. The Kendall coordination coefficients for the importance and operability scores of the indicators were 0.22 and 0.25, respectively, which were with significance. The Cronbach's coefficients α for the importance, operability, and familiarity and judgment basis scores of the indicator system were 0.938, 0.945, 0.983, and 0.962, respectively. The third level indicators with the first normalized weight value under each second level indicator are strictness of protective measures taken by inbound people with infection risk (0.048 1) , local vector energy in the insect vector characteristics (0.019 8), local altitude in the natural factor characteristics (0.028 5), accessibility of antimalarial drugs in source country in the risk of international exposure (0.034 2), local geographic relationship with source country in the risk of international transmission (0.050 1), and joint multisectoral prevention and control mechanisms in the domestic prevention and control capacity (0.044 6). Conclusion A risk assessment indicator system for imported malaria has been successfully established, which can be used as a references tool for the prevention of re-transmission of malaria due to imported malaria cases in post-elimination period in China. |
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