Malaria diagnostic capacity in health facilities in Ethiopia

Malaria Journal

Research

Henock Bogale¹  Tesfay Abreha²  Fanuel Zewde²  Zenebe Melaku²  Leykun Demeke²  Abebe Tadesse²  Sintayehu Gebresillassie²  Mekonnen Tadesse²  Yehualashet Tadesse²  Meseret Habtamu²  Bereket Alemayehu³  Dawit Teshome⁴  Damtew Yadeta⁴  Addis Mekasha⁴  Kedir Gobena⁴  Richard Reithinger⁵  Hiwot Teka⁶ 

[1] Dire Dawa Regional Health Bureau, Dire Dawa, Ethiopia;ICAP at Columbia University’s Mailman School of Public Health, Addis Ababa, Ethiopia;ICAP at Columbia University’s Mailman School of Public Health, New York, USA;Oromia Regional Health Bureau, Addis Ababa, Ethiopia;RTI International, Washington DC, USA;USAID Ethiopia, Addis Ababa, Ethiopia;USAID Ethiopia, Addis Ababa, Ethiopia;

关键词: Malaria;    Health Facility;    Artemisinin Combination Therapy;    Laboratory Personnel;    External Quality Assessment;   

DOI  :  10.1186/1475-2875-13-292

 received in 2014-02-26, accepted in 2014-07-16,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundAccurate early diagnosis and prompt treatment is one of the key strategies to control and prevent malaria in Ethiopia where both Plasmodium falciparum and Plasmodium vivax are sympatric and require different treatment regimens. Microscopy is the standard for malaria diagnosis at the health centres and hospitals whereas rapid diagnostic tests are used at community-level health posts. The current study was designed to assess malaria microscopy capacity of health facilities in Oromia Regional State and Dire Dawa Administrative City, Ethiopia.MethodsA descriptive cross-sectional study was conducted from February to April 2011 in 122 health facilities, where health professionals were interviewed using a pre-tested, standardized assessment tool and facilities’ laboratory practices were assessed by direct observation.ResultsOf the 122 assessed facilities, 104 (85%) were health centres and 18 (15%) were hospitals. Out of 94 health facilities reportedly performing blood films, only 34 (36%) used both thin and thick smears for malaria diagnosis. The quality of stained slides was graded in 66 health facilities as excellent, good and poor quality in 11(17%), 31 (47%) and 24 (36%) respectively. Quality assurance guidelines and malaria microscopy standard operating procedures were found in only 13 (11%) facilities and 12 (10%) had involved in external quality assessment activities, and 32 (26%) had supportive supervision within six months of the survey. Only seven (6%) facilities reported at least one staff’s participation in malaria microscopy refresher training during the previous 12 months. Although most facilities, 96 (79%), had binocular microscopes, only eight (7%) had the necessary reagents and supplies to perform malaria microscopy. Treatment guidelines for malaria were available in only 38 (31%) of the surveyed facilities. Febrile patients with negative malaria laboratory test results were managed with artemether-lumefantrine or chloroquine in 51% (53/104) of assessed health facilities.ConclusionsThe current study indicated that most of the health facilities had basic infrastructure and equipment to perform malaria laboratory diagnosis but with significant gaps in continuous laboratory supplies and reagents, and lack of training and supportive supervision. Overcoming these gaps will be critical to ensure that malaria laboratory diagnosis is of high-quality for better patient management.

【 授权许可】

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© Abreha et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.