Users' and health service providers' perception on quality of laboratory malaria diagnosis in Tanzania

Abstract

BackgroundCorrect diagnosis of malaria is crucial for proper treatment of patients and surveillance of the disease. However, laboratory diagnosis of malaria in Tanzania is constrained by inadequate infrastructure, consumables and insufficient skilled personnel. Furthermore, the perceptions and attitude of health service providers (laboratory personnel and clinicians) and users (patients/care-takers) on the quality of laboratory services also present a significant challenge in the utilization of the available services. This study was conducted to assess perceptions of users and health-care providers on the quality and utilization of laboratory malaria diagnostic services in six districts from three regions in Tanzania.MethodsQuestionnaires were used to collect information from laboratory personnel, clinicians and patients or care-takers.ResultsA total of 63 laboratory personnel, 61 clinicians and 753 patients/care-takers were interviewed. Forty-six (73%) laboratory personnel claimed to be overworked, poorly motivated and that their laboratories were under-equipped. About 19% (N = 12) of the laboratory personnel were lacking professional qualification. Thirty-seven clinicians (60.7%) always requested for blood smear examination to confirm malaria. Only twenty five (41.0%) clinicians considered malaria microscopy results from their respective laboratories to be reliable. Forty-five (73.8%) clinicians reported to have been satisfied with malaria diagnostic services provided by their respective laboratories. Majority (90.2%, N = 679) of the patients or care-takers were satisfied with the laboratory services.ConclusionThe findings show that laboratory personnel were not satisfied with the prevailing working conditions, which were reported to undermine laboratory performance. It was evident that there was no standard criteria for ordering malaria laboratory tests and test results were under-utilized. Majority of the clinicians and patients or care-takers were comfortable with the overall performance of laboratories, but laboratory results were having less impact on patient management.

Patients’ perception and satisfaction on quality of laboratory malaria diagnostic service in Amhara Regional State, North West Ethiopia

“…who reported 90.0 % in Tanzania [10]. When compared with available figures reported on satisfaction for the general and ART laboratory services from eastern Ethiopia and Addis Ababa, respectively, the rate of satisfaction in the current study was higher than the study conducted in eastern Ethiopia on general laboratory service [15] and study done in public hospitals in Addis Ababa on ART service [16] probably due to population difference.…”

Proficiency testing for HIV, tuberculosis and malaria diagnosis in clinical laboratories in Nigeria

“…This finding supports previous observations that, in sub-Saharan Africa, laboratory infrastructure and personnel are affected adversely by the lack of resources and prioritisation, hampering laboratory system efforts in the fight against infectious and chronic diseases. 4,5 As a result, the accessibility of laboratory testing and the quality of available services remain a serious challenge. 7 There is a dire need to create a culture of quality management in Nigerian laboratories, which will help practitioners appreciate the necessity of results validation and participation in PT and other programmes.…”

“…1,2,3 At present, the laboratory infrastructure and test quality for all types of clinical laboratories remains weak in most countries in Africa. 4,5 Laboratories applying the principles of a quality management system (QMS) generate reliable and cost-effective results; moreover, quality management is one of the major building blocks of the accreditation process in the African region. 6,7 It has become necessary to strengthen the capacity of clinical laboratories in order to ensure the generation of quality results that are suitable for use by clinicians and which benefit patients.…”

External quality assessment in resource–limited countries

“…However, focusing on improving diagnosis for one disease may lead to over-diagnosis of another illness ( 15 ). Perceptions and attitudes of healthcare providers on quality of laboratory services also affect their correct use for patient management ( 16 ). …”