[Establishment and application of quality control system for detection of schistosomiasis in Jiangsu Province I ability of serological detection among county-level personnel].
OBJECTIVE
To evaluate the ability for serological screening of schistosomiasis among county-level personnel, so as to provide the evidence for establishing the quality control system of field detection of schistosomiasis.


METHODS
The standard serum panel was prepared for the quality assessment of schistosomiasis diagnostic capability, and detected by county-level personnel in the endemic field simultaneously using single-blind method. The rates of coincidence, misdiagnosis and missed diagnosis were calculated compared with the standard results.


RESULTS
Totally 780 samples of standard serum were detected in 26 counties, and showed 134 positive and 646 negative samples. The rates of coincidence, misdiagnosis and missed diagnosis were 95.13%, 1.28% and 19.23%, respectively, and there was a significant difference between the detection results and the standard results (chi2 = 11.6053, P = 0.0007). Among the 26 counties investigated, the misdiagnosis occurred in 5 counties (19.23%) and missed diagnosis occurred in 21 counties (80.77%). The misdiagnosis rate and missed diagnosis rate of serological screening of schistosomiasis were 0-2.08% and 16.67%-33.33% in beach, hilly, water net and marshland endemic areas, respectively, and no significant differences were found in the misdiagnosis rate and the missed diagnosis rate among various types of endemic areas (chi2 = 1.590 and 1.757, P = 0.6671 and 0.6244). The rates of misdiagnosis and the missed diagnosis were 1.14% and 1.39%, and 18.18% and 20.00% in the schistosomiasis transmission-controlled and the schistosomiasis transmission-interrupted areas, respectively, and no significant differences were found in the misdiagnosis rate and missed diagnosis rate between the schistosomiasis transmission-controlled and transmission-interrupted areas (chi2 = 0.008 and 0.001, P = 0.931 and 0.974).


CONCLUSIONS
The missed diagnosis is a major cause for the reduction of quality of schistosomiasis detection at the county level in Jiangsu Province, and the coincidental detection of schistosomiasis with standard serum in the field is one of effective approaches for the control of the quality of schistosomiasis detection.
Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China.
Jian-feng
JF
Zhang
Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China.
Le-ping
LP
Sun
Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China.
Kun
K
Yang
Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China.
Qing-biao
QB
Hong
Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China.
Yun-yi
YY
Yao
Yangzhou Municipal Office of the Leading Group for the Control of Schistosomiasis and other Endemic Diseases, China.
Yang
Y
Gao
Nanjing Municipal Center for Disease Control and Prevention, China.
Chao-yong
CY
Xie
Zhenjiang Municipal Center for Disease Control and Prevention, China.
Lian-heng
LH
Zhang
Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China.
You-sheng
YS
Liang
D002681:China / Q000453:epidemiology; D003951:Diagnostic Errors; D006801:Humans; D011786:Quality Control; D012552:Schistosomiasis / Q000175:diagnosis* / Q000517:prevention & control; D012698:Serologic Tests