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目的基于One Health理念建立人感染新型禽流感风险评估指标体系,为新型禽流感的预防控制提供科学依据。方法采用文献检索和头脑风暴法初步拟定风险评估指标体系,通过德菲尔法和层次分析法相结合的方法构建风险评估指标体系并确定各级指标的权重。结果 2轮专家咨询的积极系数均为100%;第1轮二、三级指标专家权威系数均值分别为(0.876 3±0.027 1)、(0.865 3±0.037 8),第2轮二、三级指标专家权威系数均值分别为(0.875 0±0.042 4)、(0.880 6±0.029 9);第1轮二、三级指标的综合平均得分分别为(4.154 0±0.227 4)、(4.019 5±0.316 4)分,第2轮二、三级指标综合平均得分分别为(4.236 2±0.235 4)、(4.127 1±0.266 7)分;第1、2轮咨询专家意见协调系数分别为0.346 0和0.286 0,差异均有统计学意义(均P<0.05),全部专家对整个指标的评价意见协调;经过2轮专家咨询建立了人感染H7N9、H5N6等新型禽流感风险评估指标体系,该指标体系包括一级指标5个、二级指标13个、三级指标87个。结论本研究建立的新型禽流感风险评估指标体系可为新型禽流感的预测和防控以及卫生资源的合理分配提供依据,综合平均得分靠前的指标可作为目前评估人感染新型禽流感风险的基本指标。
Objective To establish a new index system of human risk assessment of bird flu based on the One Health concept and provide a scientific basis for the prevention and control of new bird flu. Methods The index system of risk assessment was initially established by literature search and brainstorming method. The index system of risk assessment was constructed by the combination of Deaf method and AHP, and the weights of indexes at all levels were determined. Results The positive coefficients of two rounds of expert consultation were all 100%. The average of the authoritative coefficient of the second and third level experts in the first round were (0.876 3 ± 0.027 1) and (0.865 3 ± 0.037 8) respectively. The second and third levels (0.875 ± 0.042 4) and (0.880 6 ± 0.029 9), respectively. The comprehensive average scores of the first and second level indicators were (4.154 0 ± 0.227 4), (4.019 5 ± 0.316 4) points, the second and third level indicators of the second round average comprehensive scores were (4.236 2 ± 0.235 4), (4.127 1 ± 0.266 7) points; first round of 1,2 consulting experts opinion coordination coefficients were 0.346 0 and 0.286 0, the differences were statistically significant (all P <0.05), all the experts coordinated the evaluation of the whole indicator; after 2 rounds of expert consultation established a new risk assessment index system of H7N9, H5N6 and other new types of human infection, the index system includes There are 5 first-level indicators, 13 second-level indicators and 87 third-level indicators. Conclusion The new index system of bird flu risk assessment established in this study can provide a basis for the prediction and prevention of new bird flu and the rational distribution of health resources. The combination of the indicators with the highest average score can serve as the basic assessment indicator for the risk of new bird flu infection index.