Volume 94, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



In 2006, the Angolan National Malaria Control Program introduced clinical guidelines for malaria case management, which included diagnostic confirmation of malaria before administration of treatment; however, diagnostic practices were inconsistent and of unknown quality. In 2009, a laboratory supervision program was implemented in Huambo Province, with the goal of assessing and improving diagnosis of malaria within the confines of available in-country resources. Supervisions were carried out from 2009 to 2014 using a standardized supervision tool by national laboratory trainers. Data from the first supervision were compared with that from the final supervision. Over the study period, the number and level of training of laboratory technicians increased, and there was a nonstatistically significant trend toward improved laboratory conditions. There was a significant reduction in false-positive microscopy slide reading ( = 0.0133). Laboratory infrastructural capacity to diagnose other communicable diseases, including syphilis, human immunodeficiency virus and hepatitis B virus infections ( = 0.0012, 0.0233 and 0.0026, respectively), also improved significantly. Laboratory supervision for malaria diagnosis found significant areas for improvement, and in combination with concurrent capacity-building activities, it improved the diagnostic capacity for malaria and other diseases. Importantly, this study demonstrates that locally available resources can be used to improve the accuracy of malaria diagnosis.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. USAID, 2008. Angola Economic Performance Assessment. Available at: http://pdf.usaid.gov/pdf_docs/PNADN864.pdf. Accessed July 23, 2015. [Google Scholar]
  2. World Health Organization, 2015. Angola: WHO Statistical Profile. Available at: http://www.who.int/gho/countries/ago.pdf?ua=1. Accessed July 23, 2015. [Google Scholar]
  3. ICF International, 2012. Angola Malaria Indicator Survey, 2011. Available at: http://dhsprogram.com/pubs/pdf/MIS11/MIS11.pdf. Accessed July 3, 2014. [Google Scholar]
  4. Fortes F, Dimbu R, Figueiredo P, Neto Z, do Rosario V, Lopes D, , 2011. Evaluation of prevalence of pfdhfr and pfdhps mutations in Angola. Malar J 10: 22.[Crossref] [Google Scholar]
  5. Somandjinga M, Lluberas M, Jobin WR, , 2009. Difficulties in organizing first indoor spray programme against malaria in Angola under the President's Malaria Initiative. Bull World Health Organ 87: 871874.[Crossref] [Google Scholar]
  6. Programa Nacional de Controlo da Malária e Direcção Nacional de Saúde Pública, Republica de Angola Ministério da Saúde, 2006. Plano Estratégico Nacional Para o Controlo da Malária em Angola 2006–2010. Luanda, Angola: Republica de Angola Ministério de Saúde. [Google Scholar]
  7. McMorrow M, Masanja M, Abdulla S, Kahigwa E, Kachur S, , 2008. Challenges in routine implementation and quality control of rapid diagnostic tests for malaria—Rufiji District, Tanzania. Am J Trop Med Hyg 79: 385390. [Google Scholar]
  8. English M, Reyburn H, Goodman C, Snow RW, , 2009. Abandoning presumptive antimalarial treatment for febrile children aged less than five years—a case of running before we can walk. PLoS Med 6: e1000015.[Crossref] [Google Scholar]
  9. Rowe A, Ponce de Leon G, Mihigo J, Santelli A, Miller N, Van-Dunem P, , 2009. Quality of malaria case management at outpatient health facilities in Angola. Malar J 8: 275.[Crossref] [Google Scholar]
  10. Thwing J, Mihigo J, Fernandes AP, Saute F, Ferreira C, Fortes F, de Oliveira AM, Newman RD, , 2009. How much malaria occurs in urban Luanda, Angola? A health facility-based assessment. Am J Trop Med Hyg 80: 487491. [Google Scholar]
  11. Okiro E, Snow R, , 2010. The relationship between reported fever and Plasmodium falciparum infection in African children. Malar J 9: 99.[Crossref] [Google Scholar]
  12. Programa Nacional Controlo da Malária, Republica de Angola Ministério da Saúde, 2013a. Manual de formação para o diagnóstico laboratorial da malária em Angola. Luanda, Angola: Republica de Angola Ministério de Saúde. [Google Scholar]
  13. Birx D, deSouza M, Nkengasong JN, , 2009. Laboratory challenges in the scaling up of HIV, TB, and malaria programs. Am J Clin Pathol 131: 849851.[Crossref] [Google Scholar]
  14. Programa Nacional Controlo da Malária, Republica de Angola Ministério da Saúde, 2013b. Garantia de qualidade em microscopia da malária: Estratégia operacional para implementação a nível municipal. Luanda, Angola: Republica de Angola Ministério de Saúde. [Google Scholar]
  15. Fancony C, Sebastiao Y, Pires J, Gamboa D, Nery S, , 2013. Performance of microscopy and RDTs in the context of a malaria prevalence survey in Angola: a comparison using PCR as the gold standard. Malar J 12: 284287.[Crossref] [Google Scholar]
  16. Ohrt C, Purnomo M, Sutamihardja MA, Tang D, Kain KC, , 2002. Impact of microscopy error on estimates of protective efficacy in malaria-prevention trials. J Infect Dis 186: 540546.[Crossref] [Google Scholar]
  17. Ohrt C, Obare P, Nanakorn A, Adhiambo C, Awuondo K, O'Meara WP, Remich S, Martin K, Cook E, Chretien JP, Lucas C, Osoga J, McEvoy P, Owaga ML, Odera JS, Ogutu B, , 2007. Establishing a malaria diagnostics centre of excellence in Kisumu, Kenya. Malar J 6: 79.[Crossref] [Google Scholar]
  18. Coleman RE, Maneechai N, Rachaphaew N, Kumpitak C, Miller RS, Soyseng V, Thimasarn K, Sattabongkot J, , 2002. Comparison of field and expert laboratory microscopy for active surveillance for asymptomatic Plasmodium falciparum and Plasmodium vivax in western Thailand. Am J Trop Med Hyg 67: 141144. [Google Scholar]
  19. Maguire JD, Lederman ER, Barcus MJ, O'Meara WA, Jordon RG, Duong S, Muth S, Sismadi P, Bangs MJ, Prescott WR, Baird JK, Wongsrichanalai C, , 2006. Production and validation of durable, high quality standardized malaria microscopy slides for teaching, testing and quality assurance during an era of declining diagnostic proficiency. Malar J 5: 92.[Crossref] [Google Scholar]
  20. Fancony C, Gamboa D, Sebastiao Y, Hallett R, Sutherland C, Sousa-Figueiredo JC, Nery SV, , 2012. Various pfcrt and pfmdr1 genotypes of Plasmodium falciparum cocirculate with P. malariae, P. ovale spp., and P. vivax in northern Angola. Antimicrob Agents Chemother 56: 52715277.[Crossref] [Google Scholar]

Data & Media loading...

Supplementary PDF

  • Received : 14 Aug 2015
  • Accepted : 10 Nov 2015
  • Published online : 02 Mar 2016

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error