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基于“同一健康”理念构建山区型人兽共患内脏利什曼病综合防控能力评价指标体系

[Construction of an evaluation index system for the capability of comprehensive control of mountain - type zoonotic visceral leishmaniasis based on the One Health concept].

作者信息

Liu J, Zhou Z, Zhang X, Huang L, Luo Z, Chen S, Zhang Y, Li S

机构信息

School of Global Health, Chinese Center for Tropical Diseases Research and Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.

One Health Center, Shanghai Jiao Tong University and The University of Edinburgh, Shanghai 200025, China.

出版信息

Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2024 Feb 2;35(6):545-556. doi: 10.16250/j.32.1374.2023176.

Abstract

OBJECTIVE

To construct an evaluation index system for the capability of comprehensive control of mountain-type zoonotic visceral leishmaniasis based on the One Health concept, so as to provide insights into the control and elimination of mountain-type zoonotic visceral leishmaniasis using the One Health approach.

METHODS

A preliminary evaluation index system was constructed based on literature review, panel discussions and field surveys. Thirty-three experts were selected from 7 provincial disease control and prevention centers in Beijing Municipality, Hebei Province, Shanxi Province, Henan Province, Sichuan Province, Shaanxi Province and Gansu Province where mountain-type zoonotic visceral leishmaniasis was endemic, and two rounds of expert consultations were conducted to screen the indicators. The positive coefficient, degree of concentration, degree of coordination, and authority of the experts were calculated, and the normalized weights of each index were calculated with the analytic hierarchy process.

RESULTS

The response rates of questionnaires during two rounds of expert consultation were both 100.00% (33/33), and the authority coefficients of the experts were 0.86 and 0.88, respectively. The coefficients of coordination among experts on the rationality, importance, and operability of the indicators were 0.392, 0.437, 0.258, and 0.364, 0.335, 0.263, respectively (all values < 0.05). Following screening, the final evaluation index system included 3 primary indicators, 17 secondary indicators, and 50 tertiary indicators. The normalized weights of primary indicators "external environment", "internal support" and "comprehensive control" were 16.98%, 38.73% and 44.29%, respectively. Among the secondary indicators of the primary indicator "external environment", the highest weight was seen for natural environment (66.67%), and among the secondary indicators of the primary indicator "internal support", the lowest weight was seen for the scientific research for visceral leishmaniasis control (8.26%), while other indicators had weights of 12.42% to 13.38%. Among the secondary indicators of the primary indicator "comprehensive control", the weight was 16.67% for each indicator.

CONCLUSIONS

An evaluation index system has been constructed for the capability of comprehensive control of mountain-type zoonotic visceral leishmaniasis based on the One Health concept. In addition to assessment of the effect of conventional mountain-type zoonotic visceral leishmaniasis control measures, this index system integrates the importance of top-level design, organizational management, and implementation of control measures, and includes indicators related to multi-sectoral cooperation.

摘要

目的

基于“同一健康”理念构建山区型人兽共患内脏利什曼病综合防控能力评价指标体系,为运用“同一健康”方法防控和消除山区型人兽共患内脏利什曼病提供参考。

方法

通过文献研究、专家小组讨论和现场调查构建初步评价指标体系。从山区型人兽共患内脏利什曼病流行的北京市、河北省、山西省、河南省、四川省、陕西省和甘肃省7个省级疾病预防控制中心选取33名专家,进行两轮专家咨询以筛选指标。计算专家的积极性系数、集中度、协调度和权威程度,并采用层次分析法计算各指标的规范化权重。

结果

两轮专家咨询问卷的回复率均为100.00%(33/33),专家权威系数分别为0.86和0.88。专家对指标合理性、重要性和可操作性的协调系数分别为0.392、0.437、0.258和0.364、0.335、0.263(均P<0.05)。筛选后,最终评价指标体系包括3个一级指标、17个二级指标和50个三级指标。一级指标“外部环境”“内部支撑”和“综合防控”的规范化权重分别为16.98%、38.73%和44.29%。一级指标“外部环境”的二级指标中,自然环境权重最高(66.67%);一级指标“内部支撑”的二级指标中,内脏利什曼病防治科研权重最低(8.26%),其他指标权重为12.42%~13.38%。一级指标“综合防控”的二级指标中,各指标权重均为16.67%。

结论

基于 “同一健康” 理念构建了山区型人兽共患内脏利什曼病综合防控能力评价指标体系。该指标体系除评估传统山区型人兽共患内脏利什曼病防控措施的效果外,还整合了顶层设计、组织管理及防控措施实施的重要性,并纳入了多部门合作相关指标。

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