【摘要】 目的 对2008—2023年梧州市乙型病毒性肝炎（乙肝）报告质量进行分析，为当地优化监测方案、提高报告准确性、精准研判流行现状提供科学依据，助力区域乙肝防控工作提质增效。方法 基于“疾病监测信息报告管理系统”数据及2018年、2023年、2024年的3次乙肝诊断符合率专项调查结果，采用分段回归模型分析重复报告率的时间变化特征，构建多元线性回归模型分析重复报告率对发病率的影响。结果 2008—2023年共报告乙肝本地病例91 471例。其中，系统重卡18 605例，重复报告率为20.34%；人工重卡4 718例，重复报告率为6.72%。急性乙肝、慢性乙肝重复报告率曲线均在2017年、2019年出现断点，以2008—2016年、2017—2018年、2019—2023年为研究时段构建的分段模型显示，系统查重急性乙肝曲线斜率（β）分别为0.47(P<0.001)、0.44（贝叶斯因子=3.960）、0.30(P=0.011)，慢性乙肝β分别为0.69(P=0.047)、2.93（贝叶斯因子=3.960）、4.08(P=0.002)；二次查重急性乙肝β分别为0.47(P<0.001)、0.45（贝叶斯因子=3.960）、0.18(P=0.024)，慢性乙肝β分别为0.67(P=0.021)、0.51（贝叶斯因子=3.960）、2.51(P<0.001)。根据报告附加卡（附卡）信息，急性乙肝诊断符合率为4.36%，慢性乙肝诊断符合率为48.48%。2018年、2023年、2024年乙肝诊断符合率专项调查中，诊断符合率分别为76.25%、97.52%、67.76%。市级、县级医疗机构与乡镇级医疗机构诊断符合率间差异有统计学意义（市级与乡镇级比较，χ~2=29.165；县级与乡镇级比较，χ~2=31.997,P值均<0.001）。结论 梧州市乙肝监测报告主要存在重复报告率较高、诊断符合率较低两大问题，基层医疗机构检测能力薄弱，对诊断标准掌握不足，在一定程度上影响数据质量，对疾病负担评估、流行趋势研判及防控效果评价造成影响。今后需从技术优化、政策协同、能力建设和质量管理4个方面进行系统干预。更多还原

【Abstract】 Objective To analyze quality of viral hepatitis type B(hereinafter referred to as hepatitis B) reports in Wuzhou from 2008 to 2023, providing a scientific basis for optimizing surveillance regimen, improving accuracy of reports, precisely judging the current epidemic trend, and helping improve quality and efficiency of regional hepatitis B control and prevention. Methods Based on the data from the National Disease Surveillance Information Reporting Management System and the special survey results of the three diagnostic accordance rates in 2018, 2023 and2024, a segmented regression model was used to identify the temporal changes in the duplicate reporting rate, and a multiple linear regression model was constructed to analyze the impact of the duplicate reporting rate on the incidence rate. Results A total of 91 471 hepatitis B local cases were reported between2008 and 2023. During this period, the system reported 18 605 duplicate cases, with a duplicate reporting rate of 20.34%; in addition, manual card checking reported 4 718 duplicate cases, with a duplicate reporting rate of 6.72%. The duplicate reporting rate curves for acute hepatitis B and chronic hepatitis B both showed breakpoints in 2017 and 2019. The segmented model constructed using the study periods of 2008-2016,2017-2018, and 2019-2023 showed that the slope of curve(β) for the system duplicate check of acute hepatitis B was 0.47(P<0.001), 0.44(Bayes factor=3.960), and 0.30(P=0.011), respectively; for chronic hepatitis B, the β value was 0.69(P=0.047), 2.93(Bayes factor=3.960), and 4.08(P=0.002), respectively.For the secondary duplicate check, the β value for acute hepatitis B was 0.47(P<0.001), 0.45(Bayes factor=3.960), and 0.18(P=0.024), respectively; for chronic hepatitis B, the β value was 0.67(P=0.021), 0.51(Bayes factor=3.960), and 2.51(P<0.001), respectively. According to special survey on the rate of report additions, the diagnostic accordance rate for acute hepatitis B was 4.36%, and for chronic hepatitis B it was48.48%. In the special investigations on hepatitis B diagnostic accordance rates conducted in 2018, 2023,and 2024, the diagnostic accordance rates were 76.25%, 97.52%, and 67.76%, respectively. There were statistically significant differences in the diagnostic accordance rates between municipal/county-level medical institutions and township-level medical institutions(comparison between municipal and townshiplevels: χ~2=29.165; comparison between county-and township-levels: χ~2=31.997, both P<0.001).Conclusions The hepatitis B surveillance reports in Wuzhou face two primary challenges: a high rate of duplicate reports and a low rate of diagnostic accordance, compounded by the weak diagnostic capacity of primary healthcare institutions and their insufficient mastery of diagnostic standards, which further affect the data quality, hindering the accurate assessment of disease burden, analysis of epidemiological trends, and evaluation of prevention and control efforts. Systematic intervention is required across four dimensions:technological optimization, policy coordination, capacity building, and quality control.更多还原