Performance Evaluation of Laboratory Professionals on Malaria Smear Microscopy in Hawassa City, Southern Ethiopia
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Date
2014-06
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Addis Ababa University
Abstract
Background: Microscopic diagnosis of Geimsa stained thick and thin blood films by skilled
microscopists has remained the standard laboratory method for the diagnosis of malaria.
However, diagnosis of malaria with this method is problematic since interpretation of results
requires considerable expertise particularly at low parasite level.
Objective: The objective of the study was to evaluate the performance of laboratory
professionals in diagnosis of malaria/plasmodium species in Hawassa city.
Methods: A cross-sectional study design was employed. Among a total of eighty laboratory
professionals working in public and private health facilities, seventy two were willing to
participate with a response rate of 90%(72/80). Information on demographic characteristics was
collected using a self-administered questionnaire. A total of 10 pre-validated panels of malaria
slides were then distributed to assess laboratory professionals' performances on detection,
differentiation of common species of malaria and quantification of parasite density.
Results: The mean age of the participants was 27 (SD= 4.1) years and more than half of
participants (56.9%) were female. Thirty-two (44.4%) of the participants were from two
government hospitals, 9(12.5%) were from three private hospitals and 31(43.1%) were from six
government health centers. Fourteen (19.4%) of participants correctly reported all the ten
distributed slides and 58(80.6%) missed at least one slide. Overall, the sensitivity and specificity
of participants in detection of malaria parasites were 82% and 96.5% respectively and had 88%
agreement with reference readers. The overall agreement between participants and reference
readers for identification of malaria species was 74.3%; relatively the agreement was lower for
government health centers (69%).
Conclusion: The overall sensitivity and specificity of participants in detection of malaria
parasites were 82% and 96.5% respectively; however, they had low (74.3%) agreement in
identification of different species of malaria. Especially, lower agreement was reported for
parasites at low density and identification of mixed infection. Participants from government
health center were found to have low performances in identification of malaria parasite.
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Keywords
Laboratory Professionals, Malaria Smear Microscopy