Erhart A, Thang N D, Xa N X, Thieu N Q, Hung L X, Hung N Q, Nam N V, Toi L V, Tung N M, Bien T H, Tuy T Q, Cong L D, Thuan L K, Coosemans M, D'Alessandro U
Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.
Trans R Soc Trop Med Hyg. 2007 Mar;101(3):216-25. doi: 10.1016/j.trstmh.2006.07.003. Epub 2006 Sep 18.
The health information system (HIS) is a key component of control programs and its accuracy is necessary for the assessment of disease risks, the formulation of priorities and the evaluation of the cost-effectiveness of different interventions. In order to assess the quality of the HIS in estimating malaria morbidity in Vietnam, we compared data obtained by a 2-year active (ACD) and passive case detection (PCD) study with those routinely collected at the local commune health centres (CHC) at three sites having different malaria epidemiology. The majority of malaria cases (80-95%) detected by ACD were missed by the HIS. Similarly, most malaria cases (50-90%) detected by PCD were also missed by the HIS, and this was proportional to the number of active private practitioners. Reasons for this low sensitivity are low CHC attendance, high attendance at private health facilities, widespread self-medication and attendance at central health facilities. In conclusion, although malaria has sharply decreased in Vietnam over the past 10 years, the current HIS greatly underestimates the malaria burden. Involvement of the private sector and the establishment of sentinel sites might improve the quality of data and the relevance of HIS in malaria control.
卫生信息系统（HIS）是防控项目的关键组成部分，其准确性对于评估疾病风险、确定工作重点以及评估不同干预措施的成本效益至关重要。为了评估越南卫生信息系统在估计疟疾发病率方面的质量，我们将一项为期两年的主动病例发现（ACD）和被动病例发现（PCD）研究获得的数据，与在三个疟疾流行病学情况不同的地点的当地社区卫生中心（CHC）常规收集的数据进行了比较。主动病例发现检测出的大多数疟疾病例（80%-95%）未被卫生信息系统记录。同样，被动病例发现检测出的大多数疟疾病例（50%-90%）也未被卫生信息系统记录，且这与个体开业医生的数量成正比。敏感性低的原因包括社区卫生中心就诊率低、私立卫生机构就诊率高、广泛的自我用药以及前往中心卫生机构就诊。总之，尽管越南在过去10年中疟疾发病率大幅下降，但当前的卫生信息系统极大地低估了疟疾负担。私营部门的参与和设立哨点可能会提高数据质量以及卫生信息系统在疟疾防控中的相关性。
