[Construction of a risk assessment indicator system for re-establishment of imported malaria].

To create a risk assessment indicator system for re-establishment of imported malaria.The risk assessment indicator system for re-establishment of imported malaria was preliminarily constructed through literature review and thematic discussions. A total of 26 malaria control experts were selected to carry out a two-round Delphi consultation of the indicator system. The active coefficient, authority coefficient and coordination coefficient of the experts and the coefficient of variation on each indicator were calculated for indicator screening and the weight of each indicator was calculated. The reliability of the indicator system was evaluated using Cronbach's coefficient α, and the content validity of the indicator system was evaluated using the authority coefficient of the expert, while the structural validity of the indicator system was evaluated using Kaiser-Meyer-Olkin (KMO) test and factor analysis.Two rounds of Delphi expert consultations were completed by 23 malaria control experts, and a risk assessment indicator system for re-establishment of imported malaria was constructed, including 3 primary indicators, 7 secondary indicators, and 21 tertiary indicators. The active coefficient (100.00% vs. 88.46%; P < 0.01) and coordination coefficient of the expert (0.372 vs. 0.286; P < 0.01) were significantly greater in the second round of the Delphi expert consultation than in the first round. After the second round of the Delphi expert consultation, the authority coefficient of the experts ranged from 0.757 to 0.930 on each indicator, and the coefficients of variation were 0.098 to 0.136, 0.112 to 0.276 and 0.139 to 0.335 for the primary, secondary and tertiary indicators, respectively. The overall Cronbach's coefficient α of the indicator system was 0.941, and there were significant differences in the KMO values for primary (KMO value = 0.523; χ2 = 18.192, P < 0.05), secondary (KMO value = 0.694, χ2 = 51.499, P < 0.01) and tertiary indicators (KMO value = 0.519; χ2 = 477.638, P < 0.01), while the cumulative contribution rate of six principal components in the tertiary indicators was 84.23%. The normalized weights of three primary indicators of the source of infection, transmission condition and control capability were 0.337, 0.333 and 0.329, and the three secondary indicators with the greatest normalized weights included the number of imported cases and malaria parasite species (0.160), introduction of imported cases in China and medical care seeking (0.152), vector species and density (0.152), while the five tertiary indicators with the greatest normalized weights included the malaria parasite species of imported cases (0.065), vector populations (0.064), and the time interval from onset to medical care seeking (0.059), number of imported cases (0.056), and the time interval from medical care seeking to definitive diagnosis (0.055).A risk assessment indicator system for re-establishment of imported malaria is successfully created, which provides insights into the assessment of the risk of re-establishment of imported malaria and management of key high-risk factors in malaria-eliminated areas.［摘要］目的 构建输入性疟疾再传播风险评估指标体系。方法 通过文献综述、专题讨论初步构建输入性疟疾再传播风险评估指标体系。选择26名疟疾防治专家, 采用德尔菲法对指标体系开展2轮专家咨询, 根据专家对每项指标的熟悉程度、判断依据和重要性评价计算专家积极系数、专家权威系数、专家协调系数、各指标变异系数, 根据上述结果进行指标筛选并计算各指标权重; 采用Cronbach’s α系数评价指标体系信度, 采用专家权威程度系数评价指标体系的内容效度, 采用KMO检验和因子分析评价指标体系的结构效度。结果 共23名专家完成2轮专家咨询, 最终构建了一个包含3个一级指标、7个二级指标、21个三级指标的输入性疟疾再传播风险评估指标体系。第2轮专家积极系数 (100.00% vs. 88.46%) 和专家协调系数 (0.372 vs. 0.286, P 均< 0.01) 均高于第1轮。第2轮专家咨询后, 各级指标专家权威程度系数为0.757~0.930, 一、二、三级指标变异系数分别为0.098~0.136、0.112~0.276、0.139~0.335; 指标体系整体Cronbach’s α系数为0.941; 一 (KMO 值= 0.523, χ2 = 18.192, P < 0.05)、二 (KMO 值= 0.694, χ2 = 51.499, P < 0.01)、三级指标 (KMO 值=0.519, χ2 = 477.638, P < 0.01) KMO值均有统计学意义; 三级指标6个主成分累积贡献率为84.23%。传染源、传播条件及防控能力3个一级指标归一化权重分别为0.337、0.333和0.329; 归一化权重居前3位的二级指标依次为输入性病例数及虫种 (0.160)、输入性病例入境及就诊情况 (0.152)、媒介种类及密度 (0.152); 归一化权重值居前5位的三级指标依次为输入性病例虫种 (0.065)、媒介种群 (0.064)、患者发病至就诊时间间隔 (0.059)、输入性病例数 (0.056) 及从就诊至确诊时间间隔 (0.055)。结论 成功构建了输入性疟疾再传播风险评估指标体系, 为消除后开展输入性疟疾再传播风险评估和加强重点风险因素防控提供了科学依据。.