Abstract
张倩,唐光鹏,刘慧慧,邹志霆,姚光海,肖洁华,谢荣恒,马会来.贵州省戊型肝炎报告病例增加原因的调查[J].Chinese journal of Epidemiology,2015,36(3):228-231
贵州省戊型肝炎报告病例增加原因的调查
Investigation on the causes of increased hepatitis E cases reported in Guizhou province
Received:November 07, 2014  
DOI:10.3760/cma.j.issn.0254-6450.2015.03.008
KeyWord: 戊型肝炎  疾病报告  疾病监测
English Key Word: Hepatitis E  Disease reporting  Disease surveillance
FundProject:
Author NameAffiliationE-mail
Zhang Qian Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Diseases
Chinese Field Epidemiology Training Project, Chinese Center for Disease Control and Prevention, Beijing 102206, China 
 
Tang Guangpeng Guizhou Provincial Center for Disease Control and Prevention  
Liu Huihui Chinese Field Epidemiology Training Project, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Zou Zhiting Guizhou Provincial Center for Disease Control and Prevention  
Yao Guanghai Chinese Field Epidemiology Training Project, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Guizhou Provincial Center for Disease Control and Prevention 
 
Xiao Jiehua Chinese Field Epidemiology Training Project, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Hunan Provincial Center for Disease Control and Prevention 
 
Xie Rongheng Chinese Field Epidemiology Training Project, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Guizhou Guiyang Center for Disease Control and Prevention 
 
Ma Huilai Chinese Field Epidemiology Training Project, Chinese Center for Disease Control and Prevention, Beijing 102206, China mahl@chinacdc.cn 
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Abstract:
      目的 分析贵州省戊型肝炎(戊肝)报告病例增加的原因,探讨医疗机构在戊肝临床和实验室诊断中存在的问题,为完善监测系统提供参考。方法 选择2007-2011年贵州省报告病例数较多且2011年报告病例数突然增高的6家医院,通过查阅住院病历、检验科检测结果、访谈医生等,对报告病例进行核实调查。结果 共核实2007-2011年戊肝报告病例354例,136例符合戊肝诊断标准,符合率为38.42%。不同年度、医院及报告科室戊肝符合率的差异有统计学意义。2011年医院报告戊肝病例符合率较低(27.66%),6家医院符合率最低者分别为0和18.18%;非传染科报告的戊肝病例占总病例数的61.30%,且符合率(8.29%)显著低于传染科(86.13%)。2011年医院检验科戊肝检测阳性数和阳性率均较往年增高。结论 贵州省戊肝报告病例增加的主要原因为医院提高了戊肝检测数量,但诊断符合率较低。建议相关医疗机构加强戊肝诊断和病例报告的培训。
English Abstract:
      Objective To analyze causes of growing hepatitis E (HE) cases reported in Guizhou province,and probe into existing problems faced by medical institutions in diagnosis of clinical and laboratory-confirmed cases,for the purpose of improving the quality of HE surveillance system. Methods Six hospitals reporting greater HE cases from 2007 to 2011 were pinpointed,whose reported cases rose suddenly in 2011. Such cases were investigated by means of impatient medical record review,results of laboratory test and clinician interview. Results 136 of the 354 reported HE cases investigated were found compliant with the diagnostic criteria of HE with an accordance rate of 38.42%. Difference of the HE diagnostic accordance rate among individual years,hospitals and reporting departments was statistically significant. Such rate of hospital reports was found to be the lowest in 2011,ranging from 0 to 18.18% respectively;HE cases reported by non-infectious departments accounted for 61.30% of total cases reported,with its accordance rate considerably below the infectious departments (8.29%). HE positive cases and HE positive rate in 2011 were significantly higher than that of preceding years. Conclusion Such increase of reported HE cases in 2011 in the province was mostly attributable to more HE laboratory tests made by the hospitals,yet the accordance rates were lower than satisfactory. In this regard,the medical institutions in question were advised to enhance their competency training for HE diagnosis and case report quality.
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