[Evaluation on Hepatitis B surveillance models at surveillance pilot points in China, 2013-2015].

Objective: To evaluate the effects on Hepatitis B surveillance models at the surveillance pilot points in China. Methods: Hepatitis B related records kept at the surveillance pilot points were downloaded from NNDRS. Data concerning proportion of unclassified Hepatitis B cases, consistency of additional records and the accuracy of reported acute Hepatitis B cases were evaluated. Results: The proportion of unclassified Hepatitis B cases was decreasing year by year (P<0.05), from 32.07% in 2012 to 4.26% in 2015, with Kappa as 0.768, 0.821 and 0.836 respectively in 2013-2015. The accuracy of reported acute Hepatitis B was improving (P<0.05), from 55.77% in 2013 to 74.49% in 2015. Conclusions: Additional records and blood testings on acute Hepatitis B cases seemed to be effective in improving the accuracy of Hepatitis B reporting system and decreasing the proportion of unclassified Hepatitis B cases. We suggested that this model of surveillance could be applied elsewhere in the nation to improve the quality of report system on Hepatitis B.目的： 对2013－2015年中国乙型肝炎（乙肝）监测试点实施的效果进行评价。为提高乙肝监测质量提供参考依据。 方法： 下载2012－2015年传染病报告信息管理系统的200个监测点乙肝报告病例个案表及其附卡，分别从3个方面进行实施效果评价：①未分类乙肝病例所占比例；②附卡信息及报告类型一致性分析；③急性乙肝病例报告的准确性。采用EpiData 3.0软件建立数据库，SPSS 22.0软件分析，计算构成比、趋势χ(2)检验和一致性检验，计算Kappa值。 结果： 未分类乙肝报告病例比例从开展监测试点项目前的32.07%下降到2015年项目实施后的4.26%，且呈现逐年下降的趋势（趋势χ(2)=24 988，P<0.05）；2013－2015年通过附卡信息诊断的类型及报告类型一致性分析，2013、2014和2015年的Kappa值分别为0.768、0.821和0.836；2013－2015年监测试点地区急性乙肝报告准确率为55.77%~74.49%，且呈现逐年升高趋势（趋势χ(2)=97，P<0.05）。 结论： 中国乙肝监测试点项目开展取得较明显效果，急性乙肝报告病例诊断准确性逐年提高，未分类乙肝病例的比例降低。建议全国范围内推广这种监测模式，提高全国乙肝病例报告质量。.