Malaria diagnostic capacity in health facilities in Ethiopia

Abstract

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.

Malaria Diagnostic Capacity of Private Health Facilities in Ethiopia

“…But interruption of power supplies were reported as a challenge for ensuring provision of malaria microscopy services as per the national recommendations. This finding was in agreement with Abreha et al (2014) reported public health facilities suffered from interruption of electric power [18].…”

Insuficiencias cognoscitivas para el diagnóstico microscópico de la malaria de técnicos de la red laboratorios de Luanda, Angola

“…Son estos precisamente los aspectos más importantes que debe conocer el médico para establecer un tratamiento adecuado y eficiente en un paciente con paludismo (10,11).…”

Hubungan Program Penanggulangan Malaria dengan Kasus Malaria di Kabupaten Lahat Tahun 2016

“…Hasil penelitian di Ethiopia menunjukkan hal yang sama dimana sebagian besar fasilitas kesehatan memiliki mikroskop binokular (79%), akan tetapi hanya 7% yang memiliki reagen dan persediaan yang diperlukan untuk melakukan mikroskop malaria. 23 Perlunya penyediaan stok obat ACT yang merata baik untuk wilayah LCI, MCI, dan HCI sebagai upaya pencegahan malaria apabila adanya kasus. Faktor stok obat ACT yang tidak mencukupi di Dinas Kesehatan Kabupaten Lahat menyebabkan distribusi ACT tidak merata dan tidak seimbang antara kebutuhan dengan yang didapatkan, penelitian di Kenya Barat menunjukkan hal yang sama bahwa ketersedian ACT masih menjadi tantangan daerah endemis malaria di Kenya Barat.…”