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. 2020 Sep 18;13(1):447.
doi: 10.1186/s13104-020-05290-0.

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

Akili K Kalinga  1   2 , Saidi Mgata  3 , Reginald A Kavishe  4 , Lucas Mahikwano  3 , Lucky Temu  3 , Christopher Mswanya  5 , Charles Mwanziva  5 , George Amoo  6 , Edwin Kamau  7 , Brian Vesely  7 , Deus S Ishengoma  8   9   10
Affiliations

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

Akili K Kalinga et al. BMC Res Notes. .

Abstract

Objective: Good 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.

Results: Of 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.

Keywords: External quality assessment; Malaria; Microscopy; Military health facility; Proficiency testing; Tanzania; Total quality index.

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Conflict of interest statement

Authors declare no competing interests.

Figures

Fig. 1
Fig. 1
True and false rate of test results among blood smears reported by MHFs at baseline
Fig. 2
Fig. 2
Trends of TQI on cross-checking blood smear by health facilities
Fig. 3
Fig. 3
Trends of proficiency testing average scores by health facility over time
See this image and copyright information in PMC

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References

    1. WHO . Guidelines for theTreatment of Malaria. 3. Geneva: World Health Organization; 2015.
    1. Gething PW, Battle KE, Bhatt S, Smith DL, Eisele TP, Cibulskis RE, et al. Declining malaria in Africa: improving the measurement of progress. Malar J [Internet]. 2014;13(1):1–5. - PMC - PubMed
    1. WHO/FIND/CDC. Malaria Rapid Diagnostic Test Per formance: Summar y results of WHO product testing of malaria RDTs: rounds 1-6 (2008–2015) [Internet]. Vol. 6. 2015.
    1. WHO/CDC/CLSI. Malaria Microscopy quality assurance mannual; Version 2. ; ISBN 978 92 4 154939 4. 2016. 113–124.
    1. Laktabai J, Platt A, Menya D, Turner EL, Aswa D, Kinoti S, et al. A mobile health technology platform for quality assurance and quality improvement of malaria diagnosis by community health workers. PLoS ONE. 2018;13(2):1–14. - PMC - PubMed