Abstract
BackgroundMicroscopic examination of peripheral blood smear produces reliable results both about the malaria infection status and level of parasitemia. However, test results are affected by skill of the laboratory personnel, workload, condition of microscopes and quality of laboratory supplies. Therefore, continuous monitoring of the performance of laboratories is of pivotal importance in order to make timely correction.MethodsA facility based cross-sectional study was conducted from July 2017 to July 2019 to assess malaria microscopy performance among thirty malaria diagnostic laboratories in west Amhara region. Thirty slides were collected from participating laboratories every quarter. Collected slides were taken to Amhara Public Health Institute reference laboratory and re-checked by malaria microscopists who were blind to the results from health facilities. Percentage of test agreement, rates of false positive, false negative and species misdiagnosis were calculated using Excel 2010.ResultsAmong a total of 6689 slides re-checked, results of 6146 slides were the same with that of participating laboratories. The test agreement was 97.31 and 94.6% for parasite detection and species identification, respectively. Variations in the overall performance of individual laboratories were seen within a range of 81.55 to 97.27% test agreement. Results of 543 (8.12%) slides were discordant, of which 363 (5.4%), 93 (1.4%) and 87 (1.3%) slides were due to species misdiagnosis, false positive and false negative results, respectively.ConclusionThere was good test agreement between participated laboratories and Amhara Public Health Institute. More accurate performance is expected as the country is tracking to malaria elimination. Hence, further strengthening the external quality assurance program is recommended.
Highlights
Microscopic examination of peripheral blood smear produces reliable results both about the malaria infection status and level of parasitemia
Variations in the overall performance of individual laboratories were seen within a range of 81.55 to 97.27% test agreement
More accurate performance is expected as the country is tracking to malaria elimination
Summary
Microscopic examination of peripheral blood smear produces reliable results both about the malaria infection status and level of parasitemia. Test results are affected by skill of the laboratory personnel, workload, condition of microscopes and quality of laboratory supplies. Continuous monitoring of the performance of laboratories is of pivotal importance in order to make timely correction. Malaria is a febrile disease caused by intracellular haemoparasites of the genus Plasmodium [1]. Despite tremendous efforts have been made to combat malaria, the Amhara Public Health Institute, P.O. BOX: 477, Bahir Dar, Ethiopia. Full list of author information is available at the end of the article disease still remains a global public health problem. In. 2018, about 228 million cases and 405 thousand deaths were reported globally. About 67% of the deaths occurred among under-5 children [1]. The burden outweighs in the tropics and subtropics that the World
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