Implementation of external quality assessment of microscopy for improved parasite detection and confirmatory diagnosis of malaria in Tanzanian Military health facilities

BMC Research Notes

George Amoo¹  Saidi Mgata²  Lucas Mahikwano²  Lucky Temu²  Reginald A. Kavishe³  Deus S. Ishengoma⁴  Akili K. Kalinga⁵  Christopher Mswanya⁶  Charles Mwanziva⁶  Brian Vesely⁷  Edwin Kamau⁷ 

[1] Forgyn Health Systems Consultants, Washington, DC, USA;Henry Jackson Foundation Medical Research International, Dar es Salaam, Tanzania;Kilimanjaro Christian Medical University College, Moshi, Tanzania;National Institute for Medical Research, Dar es Salaam, Tanzania;Faculty of Pharmaceutical Sciences, Monash University, Melbourne, Australia;Harvard T.H Chan School of Public Health, Harvard University, Boston, MA, USA;National Institute for Medical Research, Dar es Salaam, Tanzania;Kilimanjaro Christian Medical University College, Moshi, Tanzania;Tanzania Peoples Defense Forces, Dar es Salaam, Tanzania;Walter Reed Army Institute of Research, Washington, DC, USA;

关键词: Malaria;    Microscopy;    External quality assessment;    Proficiency testing;    Total quality index;    Military health facility;    Tanzania;   

DOI  :  10.1186/s13104-020-05290-0

来源: Springer

【 摘 要 】

ObjectiveGood quality microscopy is critical for accurate detection and confirmation of malaria parasite infections. Microscopy relies on the skills of technicians to prepare and read slides, high quality reagents, and a good program of internal and external quality control (EQA), which are lacking in most malaria endemic settings. This study was undertaken between January 2016 and December 2018 to pilot an EQA of microscopy for improved diagnosis of malaria and patient care in Tanzanian Military health facilities.ResultsOf all blood smears crosschecked (n = 4000) at baseline, only 38.5% were incorrectly diagnosed by laboratory staff with false positive and negative rates of 46.7% and 16.4%, respectively. During the implementation of EQA, false positive and negative results decreased due to increased quality index of slide preparation and reading through supportive supervision, and retraining of laboratory personnel. There was a gradual increase of quarterly and annual total quality index for all laboratories, from 60% in 2016 to 78% in 2017 and 90% in 2018. The mean proficiency testing performance scores also increased from 75% in 2016 to 82% in 2017 and to 90% in 2018. Poor blood smear preparation and staining contributed to high false positive and negative rates while EQA helped in improvement of diagnostics.

【 授权许可】

CC BY