Malaria microscopy in primary health care centers in Khartoum State, Sudan: external quality assurance study

Abstract

Background: Adequate diagnosis of Malaria is achieved by detection and identification of malaria parasites through examination of Giemsa’s stained blood films by competent personnel.

Objective: To identify the competency of laboratory personnel of the clinical laboratories attached to primary health care centres at Khartoum State- Sudan, by applying External quality assurance (EQA) slide check.

Design: A cross-section and facility based study conducted during the period from October to December 2015.

Setting: Primary health care centres at Khartoum State, Sudan.

Subjects: The study enrolled 52 clinical laboratories.

Result: For the EQA slides, there were 262 positive slides, 199 of them were P. falciparum and 63 were P. vivax. Study subjects achieved 213 true positive results and 204 true negative results, sensitivity and specificity were 81.3%, 79% respectively. For species detection, they reported 134 true positives and 54 true negatives for P. falciparum (sensitivity 84.8%, specificity 98%); and 55 true positive and 134 true negative P. vivax (sensitivity 98%, specificity 84%). False negative results tend to be obtained when parasite load in scanty (OR: 3.64), and is likely associated with P. falciparum (OR: 1.9).

Conclusion: This study concluded that the quality of malaria microscopy for the study facilities was poor and the personnel were found of low competency. Poor infrastructure, heavy workload, and absence of training were among the factors that affect the competency of study personnel.