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

Abstract

BackgroundThe diagnosis of malaria in clinical laboratories mainly depends on blood smear microscopy and this technique remains the most widely used in Ethiopia. Despite the importance of blood smear microscopy for patient’s diagnosis and treatment, little effort has been made to precisely determine and identify sources of error in malaria smear microscopic diagnosis and quantification of parasitaemia. The main objective of the present study was to assess the laboratory practices of health care laboratories carrying out blood films microscopy.MethodsA cross sectional study was conducted in northwestern Ethiopia involving 29 health care institutes. A structured and pretested questionnaire were used to collect relevant information on the physical conditions, laboratory logistics and laboratory practices carrying out blood smear microscopy.ResultsThere was inadequacy of laboratory reagents, guidelines and materials. Most of the health institutes have been practicing re-utilization of microscope slides for malaria microscopy. The technical procedure (preparing of reagents, making of blood films and staining of the slides) were found to be below the standard in 50% of the health institutes. Refresher training and quality assessment has been done only in two and six of the health institutes in the past five years, respectively.ConclusionIn most of the health care laboratories studied, availability of laboratory logistics and technical practices for malaria microscopy were found to be below the standard set by World Health Organization. Improving logistics access for malaria microscopy at all level of health care is important to increase accuracy of diagnosis and quantification of malaria parasites. Moreover, continued training and regular supervision of the staff and implementation of quality control program in the area is also crucial.

Performance of Laboratory Professionals Working on Malaria Microscopy in Tigray, North Ethiopia

“…However, only 58% and 39.1% of the participants participated in epidemic investigation and refresher trainings. This finding is in sharp contrast with previous study done in Northwest Ethiopia [ 10 ].…”

Field Evaluation of Malaria Microscopy, Rapid Malaria Tests and Loop-Mediated Isothermal Amplification in a Rural Hospital in South Western Ethiopia

“…Malaria incidence has been declining globally in the last decade. However, in countries like Ethiopia, it remains as one of the top health problems and has been reported as one of the three leading causes of morbidity and mortality in the past years [ 3 ]. Efforts to control and eradicate malaria require a strong diagnostic capability, which should allow a prompt detection and treatment of any parasitemia patient.…”

“…Limitations of blood smear microscopy contributed to failure of the 1950–1960s WHO Global Programme to Eliminate Malaria [ 1 ]. Recent studies have shown that many clinical laboratories use only thin films [ 2 ] with low sensitivity and virtually no quality control on the results [ 3 ], which could affect both to sensitivity and specificity of the diagnostic test. These results could be even poorer when only thin films are prepared in recycled slides in laboratories without quality control and no periodical training for lab technicians[ 4 ].…”

Implementation of the integrated management of childhood illness with parasitological diagnosis of malaria in rural Ghana: health worker perceptions

“…In some parts of Uganda and Kenya, RDTs were found to be effective when used in low endemicity situations, but high false positive error rates occurred in areas with moderately high transmission [ 40 ]. It is worth noting that malaria microscopy is challenging: a study on the standardization of malaria microscopy in health facilities in Ethiopia on the availability of laboratory logistics and technical practices, concluded that most facilities fell below WHO standard [ 41 ]. Gaps were also noted in the continuity of supply of reagents and laboratory supplies for malaria microscopy in some health facilities in Ethiopia [ 42 ].…”