Performance Evaluation of Laboratory Professionals on Malaria Microscopy Among Health Facilities Found Under Defense Health Main Department In Addis Ababa & Surrounding Area, Ethiopia

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Addis Ababa University


Background: Malaria diagnosis by microscopy is the gold standard method for confirming the cases. In spite of clinical diagnosis, the inability of laboratory professionals on microscopy diagnosis has led to over as well as under diagnosis. This may result in inappropriate use of anti-malarial drugs that increases the risk of drug resistance, and other diseases are overlooked and not treated in a timely manner. Objective: To evaluate the performance of laboratory professionals in diagnosis of malaria species among selected health facilities found under Defense Health Main Department in Addis Ababa and surrounding area, Ethiopia. Method: A cross sectional study was conducted from June to July, 2015. All laboratory professionals who work in selected health facilities were included in the study. Data was collected by distributing a standardized pre-validated malaria slide panel and self-administered questionnaires. Finally, data analysis was performed using SPSS version 20 to look an association between independent variable and dependent variable. An agreement in detection and species identification of malaria parasites between participants and expert microscopists was estimated using the Kappa score. Result: The mean age of the participants was 32 ± 5.43 years. The majority of the participants 48 (80%) were males. Only 9(15%) participants used recommended quantification system. Five(8.3%) of the participants correctly reported all the distributed slides, whereas 55(91.7%) missed at least two slide. Overall, the sensitivity and specificity of performance among participants in detection of malaria parasites were 65.7% and 100% respectively. The overall agreement in performance between participants and reference readers on detection of malaria parasite was 71.4% (Kappa = 0.4) while on identification of malaria species, it was 51.1% (kappa = 0.04). Lower agreement was observed on detection and identification of slides with low parasitic density and mixed infection. Conclusion: Agreement of performance among the participants and expert microscopist in the detection of malaria parasites was better than agreement in the identification of different species of malaria. Poor agreement was reported in detection of parasites at a low density and mixed infections. Hence, malaria control program should work towards increasing the competency of lab personnel in malaria microscopy, particularly in non-malarious area of the country where the professionals have lower exposure to malaria diagnosis. Key words: Performance, Kappa test, Malaria, Blood Film



Performance, Kappa test, Malaria, Blood Film