病毒学报

我国提出的"一带一路"倡议得到越来越多国家的响应,为了防止传染病输入我国并造成本地传播,需要评估各种传染病跨境传播的可能。本文采用德尔菲法和风险矩阵相结合的分析方法,选择20名长期从事传染病防治的专家填写咨询问卷,评价俄罗斯、哈萨克斯坦两国克里米亚-刚果出血热(Crimean-Congo hemorrhagic fever,CCHF)、蜱传脑炎(Tick-borne encephalitis,TBE)输入我国的风险水平(Risk,R)。第二轮咨询结果显示,两个国家、两种疾病的输入风险可能性(Possibility,P)、后果严重性(Consequence severity,S)评分的标准差均较第一轮咨询小,提示专家意见分歧变小;第二轮专家咨询哈萨克斯坦CCHF输入风险可能性明显小于第一轮(P=0.017),其他各指标评分的均值均未高于第一轮,提示风险偏好并未随着咨询次数增加而增大;肯德尔和谐系数(Kendall’s W)为0.223,较第一轮小幅上升(0.199);两种蜱传疾病在第二轮风险矩阵中的风险水平处于低～中等范围,较第一轮(低～极高)趋于集中,第二轮咨询哈萨克斯坦CCHF输入我国风险水平平均秩次低于第一轮(P=0.027),其他无统计学差异;两轮咨询俄罗斯TBE输入我国风险可能性均高于哈萨克斯坦(P第一轮=0.008、P第二轮<0.001),第二轮风险水平平均秩次高于哈萨克斯坦(P=0.014)。以上结果已对实际工作和研究方法具有借鉴作用,终止咨询。本研究提示,我国面临TBE、CCHF输入风险虽未达高等级水平,但仍需保持适度的警惕性。

The Belt and Road initiative set forward by our country has been responded by more and more countries. In order to prevent the imported infectious diseases into China which will cause local spread,we need to assess the possibility of crossing border spread of various infectious diseases. In this paper,the Delphi method and risk level matrix analysis were combined to evaluate the risk level of Crimea-Congo hemorrhagic fever(CCHF)and tick-borne encephalitis(TBE)imported into China from Russian and Kazakhstan by selecting 20 experts who have been engaged in the prevention and control of infectious diseases for a long time to fill in the questionnaire. Results of the second round consultation showed that the standard deviation of imported possibility(P),consequence severity(S)of two diseases from two counties were smaller than those in the first round,suggesting that the divergence of opinions of experts was narrowed. The CCHF imported possibility of Kazakhstan in the second round of consultation was significantly smaller than that in the first round(P=0.017),and the mean values of other indicators' scores were not higher than those in the first round,indicating that the risk preference did not increase with the increasing times of consultation. Kendall's W coefficient in the second round was 0.223,slightly higher than that in the first round. The risk levels of two tick-borne diseases in the second round from the risk level matrix in the two countries are in the range of low to medium,which tended to be concentrated compared to the first round( low to extremely high),and the mean rank of risk level in matrix of CCHF imported possibility from Kazakhstan in the second round was lower than that of the first round(P=0.027)and there was no significant difference in other indicators;the possibilities of TBE imported from Russia to China in two rounds were higher than those from Kazakhstan( Pround 1=0.008,Pround 2<0.001),mean rank of risk level in matrix of TBE in Russian in the second round was higher than that of Kazakhstan. Because the above results had already played the role in practical work and research methods,the consultation was terminated. This study suggests that although the imported possibility of TBE and CCHF faced by China from Russian and Kazakhstan is not up to a high level,we still need to keep a moderate vigilance.