Objective: Investigate and analyze the etiology and serological diagnosis capabilities of pertussis in medical institutions in Shandong Province in 2018. Methods: Using the census method, a questionnaire survey was conducted among 603 second and above level medical institutions in Shandong Province. The deadline for the survey was December 2018, and a total of 543 questionnaires have been recovered, and the validity rate of the questionnaires was 90%. Surveyed the pertussis etiology and serology test items (pertussis IgM and IgG, pertussis nucleic acid and pertussis bacterial culture) and the start time of each test item by questionnaire. The reported cases (confirmed cases and clinically diagnosed cases) between January 1, 2012 and December 31, 2018 were derived from the Chinese Disease Control and Prevention Information System according to the onset date. We used indicators such as fixed-base development speed, chain development speed, and chain growth speed for analysis. The chi test was used to analyze the differences in the composition ratio of medical institutions with detection ability in different levels and regions, and analyze the changes in the number of reported cases before and after the development of pertussis etiology and serology testing. Results: A total of 543 medical institutions accounted for 90.0% (543/603) of all secondary and above level medical institutions in the province, 356 secondary medical institutions (65.6%), and 187 tertiary medical institutions (34.4%). There were 10 medical institutions that carry out pertussis IgM, IgG and nucleic acid testing, accounting for 1.8% (10/543) of the surveyed medical institutions respectively. 2 medical institutions that carried out bacterial culture, accounting for 0.4% of the surveyed medical institutions (2/543). 20 medical institutions have carried out the above tests (8 secondary medical institutions and 12 tertiary medical institutions), accounting for 3.7% (20/543). The proportion of tertiary medical institutions with pertussis IgM, IgG detection and nucleic acid detection capabilities [6.42% (12/187)] was significantly higher than that of secondary medical institutions [2.25% (8/356)] (χ²=6.01, P=0.014). From 2012 to 2018, the fixed base ratio development speed of reported cases was 3 834.69% in Shandong Province, among which medical institutions with etiology and serological testing capabilities reached 4 533.33%. In 13 medical institutions, the average annual number of reported cases after pertussis etiology and serological testing were higher than that of reported cases before testing. Conclusion: The ability of pertussis etiology and serology diagnosis of secondary and above medical institutions in Shandong Province needs to be improved.
目的： 调查分析2018年山东省医疗机构百日咳病原学和血清学诊断能力。 方法： 采用普查的方法，对山东省603家二级及以上医疗机构开展问卷调查。调查截至日期为2018年12月，共收回调查问卷543份，问卷有效率为90%。通过问卷调查百日咳病原学和血清学检测项目（百日咳IgM和IgG、百日咳核酸和百日咳细菌培养）及各检测项目开始时间，同时从中国疾病预防控制信息系统中导出发病日期为2012年1月1日至2018年12月31日的报告病例（确诊病例和临床诊断病例）。采用定基比发展速度、环比发展速度和环比增长速度等指标进行分析，采用χ²检验分析不同级别和地区有检测能力医疗机构的构成比差异，同时分析开展百日咳病原学和血清学检测前后的报告病例数变化情况。 结果： 543家医疗机构占全省所有二级以上医疗机构的90.0%（543/603），二级医疗机构356家（65.6%），三级医疗机构187家（34.4%）；开展百日咳IgM、IgG检测和核酸检测的医疗机构均为10家，分别占调查医疗机构的1.8%（10/543）；开展细菌培养的医疗机构2家，占调查医疗机构的0.4%（2/543）；至少开展以上一项检测者20家（二、三级医疗机构分别有8、12家），占3.7%（20/543）。三级医疗机构中具有百日咳IgM、IgG检测和核酸检测能力的占比［6.42%（12/187）］明显高于二级医疗机构［2.25%（8/356）］（χ²=6.01， P=0.014）。2012—2018年，山东省百日咳报告病例数定基比发展速度为3 834.69%，其中有病原学和血清学检测能力的医疗机构则高达4 533.33%。有13家医疗机构开展百日咳病原学和血清学检测后年均报告病例数均高于开展检测前年均报告病例数。 结论： 山东省二级及以上医疗机构百日咳病原学和血清学诊断能力有待提高。.