Clinical Medicine Research

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External Quality Assessment of Malaria Microscopy in Hawassa Health Facilities, Southern Ethiopia

Received: 01 March 2015    Accepted: 19 March 2015    Published: 23 March 2015
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Abstract

Background: Misinterpretation of malaria microscopy results can lead to inappropriate case management of malaria. The objective of this study was to assess the quality of malaria microscopy among health facilities in Hawassa city. A cross - sectional study was conducted to assess the quality of malaria microscopy diagnosis in Hawassa city health facility laboratories from November 2012 to January 2013 in Sothern Ethiopia. Validated panel malaria slides were distributed to health facilities accompanied with a questionnaire that assessed factors related to malaria microscopy improvement. Operational definitions for correct result and major and minor errors were outlined. A total of 51 laboratory professionals in 10 health facilities were surveyed with a response rate of 85%. Results were collected and data was analyzed by SPSS, and Win Pepi software. Result: Of 306 malaria slides examined in Sample 1-Sample 6 [S1-S6] only 54% of the examinations reported correctly. Considering major errors in [S1-S4], the most common errors were reporting negative for positive slide 39/83(47%), species identification error 29/83(35%) and density 15/83 (18%). In mixed Plasmodium falciparum/Plasmodium vivax (Pf/Pv) sample, only 18% of participants made correct diagnosis in identifying both Pf/Pv species. In Plasmodium negative sample 45(88.2%) of participants scored (no parasites observed) correctly. Considering S1-S4, 29 of the 165 densities reported were different from the reference density established for each slide. 53% of participants had never participated in a formal training on malaria microscopy, and among those who did, more than half were trained earlier than 2008. All of the participants reported to use tap water in preparation of working Giemsa solution. Conclusion: The present assessment revealed a poor quality of malaria microscopy in Hawassa city administration health facilities. Therefore, responsible bodies are required to improve quality of malaria microscopy, and also provide regular refreshment training for laboratory professionals in malaria microscopy. Further similar study should be conducted in large scale.

DOI 10.11648/j.cmr.20150403.11
Published in Clinical Medicine Research (Volume 4, Issue 3, May 2015)
Page(s) 63-68
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

External Quality Assessment, Malaria Microscopy

References
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[2] The Federal Democratic Republic of Ethiopia MOH. Malaria Diagnosis and Treatment Guidelines for Health Workers in Ethiopia 2nd Edition Addis Ababa July 2004
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[5] O'Meara WP, Barcus M, Wongsrichanalai C, Muth S, Jason D Maguire JD, Robert G Jordan RG, Prescott WR, McKenzie FE. Reader technique as a source of variability in determining malaria parasite density by microscopy Malaria Journal 2006, 5:118
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[7] Maguire JD, Lederman ER, Barcus MJ, O’Meara WA, Jordon RG, Duong S, Muth S, Sismadi P, Bangs MJ, Prescott WR, Baird JK, Wongsrichanalai C. Production and validation of durable, high quality standardized malaria microscopy slides for teaching, testing and quality assurance during an era of declining diagnostic proficiency. Malar J. 2006; 5:92.
[8] World Health Organization. Malaria Light Microscopy. Creating a Culture of Quality. Report of WHO SEARO/ WPRO workshop on quality assurance for malaria microscopy, 18–21 April 2005; Kuala Lumpur, Malaysia. 2005.
[9] World Health Organization: Manual of basic techniques for a health laboratory. 2nd edition.2003.
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[11] SNNPRS RHB/Malaria Consortium: Implementation Guideline for Malaria Microscopy Diagnosis Quality Assurance. Hawassa, Ethiopia. September 2008.
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[16] Milne LM, Kyi MS, Chiodini PL, Warhurst DC. Accuracy of routine laboratory diagnosis of malaria in the United Kingdom. J Clin Pathol. 1994; 47:740–742.
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[18] Kettelhut M M , Chiodini PL, Edwards H, Moody A. External quality assessment schemes raise standards: evidence from the UKNEQAS parasitology subschemes. Clin Pathol 2003; 56:927–932.
[19] McKenzie FE, Sirichaisinthop J, Miller RS, Gasser RA Jr, Wongsrichanalai C. Dependence of malaria detection and species diagnosis by microscopy on parasite density. Am J Trop Med Hyg. 2003; 69:372–376.
[20] Ohrt C, Obare P, Nanakorn A, Adhiambo C, Awuondo K, O'Meara WP, Remich S,Martin K, Cook E, Chretien JP, Lucas C, Osoga J, McEvoy P, Owaga ML, Odera JS, Ogutu B. Establishing a malaria diagnostics centre of excellence in Kisumu, Kenya Malaria Journal 2007, 6:79
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Author Information
  • Hawassa University College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Hawassa, Ethiopia

  • Hawassa University College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Hawassa, Ethiopia

  • Hawassa University College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Hawassa, Ethiopia

  • Hawassa University College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Hawassa, Ethiopia

  • SNNP Regional Health Beauro (Bureau) Public Health Laboratory, Hawassa, Ethiopia

  • Orebro University School of Health and Medical Sciences, Department of Clinical Medicine 70182, ?rebro, Sweden

  • Hawassa University College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Hawassa, Ethiopia

  • Hawassa University College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Hawassa, Ethiopia

  • Hawassa University College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Hawassa, Ethiopia

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    Bereket Zeleke, Girmay Admasu, Tigist Getachew, Endalish Kebede, Goshu Belay, et al. (2015). External Quality Assessment of Malaria Microscopy in Hawassa Health Facilities, Southern Ethiopia. Clinical Medicine Research, 4(3), 63-68. https://doi.org/10.11648/j.cmr.20150403.11

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    Bereket Zeleke; Girmay Admasu; Tigist Getachew; Endalish Kebede; Goshu Belay, et al. External Quality Assessment of Malaria Microscopy in Hawassa Health Facilities, Southern Ethiopia. Clin. Med. Res. 2015, 4(3), 63-68. doi: 10.11648/j.cmr.20150403.11

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    AMA Style

    Bereket Zeleke, Girmay Admasu, Tigist Getachew, Endalish Kebede, Goshu Belay, et al. External Quality Assessment of Malaria Microscopy in Hawassa Health Facilities, Southern Ethiopia. Clin Med Res. 2015;4(3):63-68. doi: 10.11648/j.cmr.20150403.11

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  • @article{10.11648/j.cmr.20150403.11,
      author = {Bereket Zeleke and Girmay Admasu and Tigist Getachew and Endalish Kebede and Goshu Belay and Amanuel Abraha and Dawit Yihdego and Mengistu Hailemariam and Misganaw Birhaneselassie},
      title = {External Quality Assessment of Malaria Microscopy in Hawassa Health Facilities, Southern Ethiopia},
      journal = {Clinical Medicine Research},
      volume = {4},
      number = {3},
      pages = {63-68},
      doi = {10.11648/j.cmr.20150403.11},
      url = {https://doi.org/10.11648/j.cmr.20150403.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.cmr.20150403.11},
      abstract = {Background: Misinterpretation of malaria microscopy results can lead to inappropriate case management of malaria. The objective of this study was to assess the quality of malaria microscopy among health facilities in Hawassa city. A cross - sectional study was conducted to assess the quality of malaria microscopy diagnosis in Hawassa city health facility laboratories from November 2012 to January 2013 in Sothern Ethiopia. Validated panel malaria slides were distributed to health facilities accompanied with a questionnaire that assessed factors related to malaria microscopy improvement. Operational definitions for correct result and major and minor errors were outlined. A total of 51 laboratory professionals in 10 health facilities were surveyed with a response rate of 85%. Results were collected and data was analyzed by SPSS, and Win Pepi software. Result: Of 306 malaria slides examined in Sample 1-Sample 6 [S1-S6] only 54% of the examinations reported correctly. Considering major errors in [S1-S4], the most common errors were reporting negative for positive slide 39/83(47%), species identification error 29/83(35%) and density 15/83 (18%). In mixed Plasmodium falciparum/Plasmodium vivax (Pf/Pv) sample, only 18% of participants made correct diagnosis in identifying both Pf/Pv species. In Plasmodium negative sample 45(88.2%) of participants scored (no parasites observed) correctly. Considering S1-S4, 29 of the 165 densities reported were different from the reference density established for each slide. 53% of participants had never participated in a formal training on malaria microscopy, and among those who did, more than half were trained earlier than 2008. All of the participants reported to use tap water in preparation of working Giemsa solution. Conclusion: The present assessment revealed a poor quality of malaria microscopy in Hawassa city administration health facilities. Therefore, responsible bodies are required to improve quality of malaria microscopy, and also provide regular refreshment training for laboratory professionals in malaria microscopy. Further similar study should be conducted in large scale.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - External Quality Assessment of Malaria Microscopy in Hawassa Health Facilities, Southern Ethiopia
    AU  - Bereket Zeleke
    AU  - Girmay Admasu
    AU  - Tigist Getachew
    AU  - Endalish Kebede
    AU  - Goshu Belay
    AU  - Amanuel Abraha
    AU  - Dawit Yihdego
    AU  - Mengistu Hailemariam
    AU  - Misganaw Birhaneselassie
    Y1  - 2015/03/23
    PY  - 2015
    N1  - https://doi.org/10.11648/j.cmr.20150403.11
    DO  - 10.11648/j.cmr.20150403.11
    T2  - Clinical Medicine Research
    JF  - Clinical Medicine Research
    JO  - Clinical Medicine Research
    SP  - 63
    EP  - 68
    PB  - Science Publishing Group
    SN  - 2326-9057
    UR  - https://doi.org/10.11648/j.cmr.20150403.11
    AB  - Background: Misinterpretation of malaria microscopy results can lead to inappropriate case management of malaria. The objective of this study was to assess the quality of malaria microscopy among health facilities in Hawassa city. A cross - sectional study was conducted to assess the quality of malaria microscopy diagnosis in Hawassa city health facility laboratories from November 2012 to January 2013 in Sothern Ethiopia. Validated panel malaria slides were distributed to health facilities accompanied with a questionnaire that assessed factors related to malaria microscopy improvement. Operational definitions for correct result and major and minor errors were outlined. A total of 51 laboratory professionals in 10 health facilities were surveyed with a response rate of 85%. Results were collected and data was analyzed by SPSS, and Win Pepi software. Result: Of 306 malaria slides examined in Sample 1-Sample 6 [S1-S6] only 54% of the examinations reported correctly. Considering major errors in [S1-S4], the most common errors were reporting negative for positive slide 39/83(47%), species identification error 29/83(35%) and density 15/83 (18%). In mixed Plasmodium falciparum/Plasmodium vivax (Pf/Pv) sample, only 18% of participants made correct diagnosis in identifying both Pf/Pv species. In Plasmodium negative sample 45(88.2%) of participants scored (no parasites observed) correctly. Considering S1-S4, 29 of the 165 densities reported were different from the reference density established for each slide. 53% of participants had never participated in a formal training on malaria microscopy, and among those who did, more than half were trained earlier than 2008. All of the participants reported to use tap water in preparation of working Giemsa solution. Conclusion: The present assessment revealed a poor quality of malaria microscopy in Hawassa city administration health facilities. Therefore, responsible bodies are required to improve quality of malaria microscopy, and also provide regular refreshment training for laboratory professionals in malaria microscopy. Further similar study should be conducted in large scale.
    VL  - 4
    IS  - 3
    ER  - 

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