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Abstract

Background: Inaccurate malaria results can lead to patient mismanagement, misperceptions about malaria resistance patterns and public health misinformation. All laboratories need to be able to demonstrate that their results are accurate. Establishing and maintaining a system for monitoring test accuracy is a complex, expensive and technically demanding process, which very few poor countries have been able to implement. This study described the process and assessed the feasibility of establishing a nation-wide system for improving the accuracy of malaria-related tests in peripheral laboratories in Ghana.

Does the practice of blood film microscopy for detection and quantification of malaria parasites in northwest Ethiopia fit the standard?

“…In many developing countries including Ethiopia, however, laboratory services have been neglected due to chronic under-investment and professional biases by other health care workers [10-13]. One main element of malaria control strategy is effective case management by early detection and treatment of the patients [3], which would obliviously, be economically beneficial since many African countries including Ethiopia used expensive drugs as first line anti-malaria treatment [6,7]. This study indicates that in almost all of the health institutions included in the study, there were shortage of trained human power in the area, despite the high work load for a technician reached to read as many as 87 blood film slides far above what is recommended for one technician and the ever increasing demand from the patients and other health care providers which is in agreement with previous studies [10,12].…”

“…The chance of producing scratches on the surface of the slides during cleaning of the already used slides is very high. The scratches might be well stained during the staining steps and can confuse the observer and results to false positive test results [6]. This misleads the physician and the patients will be misdiagnosed and mistreated.…”

“…Although molecular techniques for quantifying parasites have made significant progress in recent years, microscopy remains the primary technique for quantification of parasites. Microscopy is routinely relied upon as a primary endpoint measurement for epidemiological studies, intervention studies, and clinical practices [6]. Like any other developing countries of the tropical settings, the diagnosis of malaria in clinical laboratories in Ethiopia is depend almost exclusively on blood smear microscopy [7,8] and currently this technique is also widely used in parallel to rapid malaria test which become commonly available with an introduction of extension health workers in Ethiopia.…”

Assessment of the inter-rater reliability of the microscopic diagnosis of malaria in three Health Centres of Kayonza District, Eastern Province, Rwanda

“…The preparation of thick blood films has been reported to lose up to 60% of the parasites, which is a significant barrier to accurate microscopic diagnosis of malaria (Dowling & Shute, 1966). Nevertheless, with a 6 months of training technologists have been shown to increase the malaria microscopy evaluation accuracy with a notable improvement in scores from 84% to 91%, (Bates, Bekoe, & Asamoa-Adu, 2004b).…”

“…Rwanda, has responded by working to establish and maintaining quality laboratory services for accurate, reliable and timely results as required by set standards (Bates, Bekoe, & Asamoa-Adu, 2004a;MoH, 2013aMoH, , 2014. However, considering that proper maintenance of medical laboratories can be expensive requiring skilled staff, the goal of attaining desired quality control and quality assurance across Rwanda is not yet fully achieved (MoH, 2014).…”