ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization, 2011. Universal Access to Malaria Diagnostic Testing—An Operational Manual. Geneva, Switzerland: WHO.
-
2.
Molyneux M, Fox R, 1993. Diagnosis and treatment of malaria in Britain. BMJ 306: 1175–1180.
-
3.
Hanscheid T, 1999. Diagnosis of malaria: a review of alternatives to conventional microscopy. Clin Lab Haematol 21: 235–245.
-
4.
World Health Organization, 2016. Malaria Microscopy Quality Assurance Manual—Version 2. Geneva, Switzerland: WHO.
-
5.
Ashraf S, Kao A, Hugo C, Christophel EM, Fatunmbi B, Luchavez J, Lilley K, Bell D, 2012. Developing standards for malaria microscopy: external competency assessment for malaria microscopists in the Asia-Pacific. Malar J 11: 352.
-
6.
Bell D, Wongsrichanalai C, Barnwell JW, 2006. Ensuring quality and access for malaria diagnosis: how can it be achieved? Nat Rev Microbiol 4 (9 Suppl): S7–S20.
-
7.
World Health Organization, 2009. WHO Malaria Rapid Diagnostic Test Performance—Results of WHO Product Testing of Malaria RDTs: Round 2. Available at: www.who.int/malaria/publications/atoz/9789241599467/en/index.html. Accessed May 5, 2017.
-
8.
World Health Organization, 2015. Guidelines for the Treatment of Malaria, 3rd edition. Geneva, Switzerland: WHO.
-
9.
The malERA Consultative Group on Diagnoses and Diagnostics, 2011. A research agenda for malaria eradication: diagnoses and diagnostics. PLoS Med 8: e1000396.
-
10.
Amexo M, Tolhurst R, Barnish G, Bates I, 2004. Malaria misdiagnosis: effects on the poor and vulnerable. Lancet 364: 1896–1898.
-
11.
Coleman RE et al. 2006. Comparison of PCR and microscopy for the detection of asymptomatic malaria in a Plasmodium falciparum/vivax endemic area in Thailand. Malar J 5: 121.
-
12.
Zurovac D, Midia B, Ochola SA, English M, Snow RW, 2006. Microscopy and outpatient malaria case management among older children and adults in Kenya. Trop Med Int Health 11: 432–440.
-
13.
Ohrt C, Purnomo, Sutamihardja MA, Tang D, Kain KC, 2002. Impact of microscopy error on estimates of protective efficacy in malaria-prevention trials. J Infect Dis 186: 540–546.
-
14.
Wongsrichanalai C, Barcus MJ, Muth S, Sutamihardja A, Wernsdorfer WH, 2007. A review of malaria diagnostic tools: microscopy and rapid diagnostic test (RDT). Am J Trop Med Hyg 77 (Suppl 6): 119–127.
-
15.
Kahama-Maro J, D’Acremont V, Mtasiwa D, Genton B, Lengeler C, 2011. Low quality of routine microscopy for malaria at different levels of the health system in Dar es Salaam. Malar J 10: 332.
-
16.
Kachur SP, Nicolas E, Jean-François V, Benitez A, Bloland PB, Saint Jean Y, Mount DL, Ruebush TK 2nd, Nguyen-Dinh P, 1998. Prevalence of malaria parasitemia and accuracy of microscopic diagnosis in Haiti, October 1995. Rev Panam Salud Publica 3: 35–39.
-
17.
Durrheim DN, Becker PJ, Billinghurst K, 1997. Diagnostic disagreement—the lessons learnt from malaria diagnosis in Mpumalanga. S Afr Med J 87: 1016.
-
18.
Kain KC, Harrington MA, Tennyson S, Keystone JS, 1998. Imported malaria: prospective analysis of problems in diagnosis and management. Clin Infect Dis 27: 142–149.
-
19.
Kilian AH, Metzger WG, Mutschelknauss EJ, Kabagambe G, Langi P, Korte R, von Sonnenburg F, 2000. Reliability of malaria microscopy in epidemiological studies: results of quality control. Trop Med Int Health 5: 3–8.
-
20.
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: 141–144.
-
21.
O’Meara WP, McKenzie FE, Magill AJ, Forney JR, Permpanich B, Lucas C, Gasser RA Jr., Wongsrichanalai C, 2005. Sources of variability in determining malaria parasite density by microscopy. Am J Trop Med Hyg 73: 593–598.
-
22.
Gomes LT et al. 2013. Low sensitivity of malaria rapid diagnostic tests stored at room temperature in the Brazilian Amazon region. J Infect Dev Ctries 7: 243–252.
-
23.
Bell D, Perkins MD, 2008. Making malaria testing relevant: beyond test purchase. Trans R Soc Trop Med Hyg 102: 1064–1066.
-
24.
Mwangi TW, Mohammed M, Dayo H, Snow RW, Marsh K, 2005. Clinical algorithms for malaria diagnosis lack utility among people of different age groups. Trop Med Int Health 10: 530–536.
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25.
Ochola LB, Vounatsou P, Smith T, Mabaso MLH, Newton C, 2006. The reliability of diagnostic techniques in the diagnosis and management of malaria in the absence of a gold standard. Lancet Infect Dis 6: 582–588.
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26.
Barat L, Chipipa J, Kolczak M, Sukwa T, 1999. Does the availability of blood slide microscopy for malaria at health centers improve the management of persons with fever in Zambia? Am J Trop Med Hyg 60: 1024–1030.
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27.
Reyburn H et al. 2004. Overdiagnosis of malaria in patients with severe febrile illness in Tanzania: a prospective study. BMJ 329: 1212.
-
28.
McMorrow ML, Masanja MI, Abdulla SM, Kahigwa E, Kachur SP, 2008. Challenges in routine implementation and quality control of rapid diagnostic tests for malaria—Rufiji District, Tanzania. Am J Trop Med Hyg 79: 385–390.
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Perkins BA et al. 1997. Evaluation of an algorithm for integrated management of childhood illness in an area of Kenya with high malaria transmission. Bull World Health Organ 75 (Suppl 1): 33–42.
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Evans JA, Adusei A, Timmann C, May J, Mack D, Agbenyega T, Horstmann RD, Frimpong E, 2004. High mortality of infant bacteraemia clinically indistinguishable from severe malaria. QJM 97: 591–597.
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31.
Nateghpour M, Edrissian G, Raeisi A, Motevalli-Haghi A, Farivar L, Mohseni G, Rahimi-Froushani A, 2012. The role of malaria microscopy training and refresher training courses in malaria control program in Iran during 2001–2011. Iran J Parasitol 7: 104–109.
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Namagembe A et al. 2011. Improved clinical and laboratory skills after team-based, malaria case management training of health care professionals in Uganda. Malar J 11: 44.
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33.
Kiggundu M, Nsobya SL, Kamya MR, Filler S, Nasr S, Dorsey D, Yeka A, 2011. Evaluation of a comprehensive refresher training program in malaria microscopy covering four districts of Uganda. Am J Trop Med Hyg 84: 820–824.
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34.
Moura S, Fançony C, Mirante C, Neves M, Bernardino L, Fortes F, Sambo MR, Brito M, 2014. Impact of a training course on the quality of malaria diagnosis by microscopy in Angola. Malar J 13: 437.
-
35.
Aiyenigba B, Ojo A, Aisiri A, Uzim J, Adeusi O, Mwenesi H, 2017. Immediate assessment of performance of medical laboratory scientists following a 10-day malaria microscopy training programme in Nigeria. Glob Health Res Policy 2: 32.
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36.
Odhiambo F et al. 2017. Factors associated with malaria microscopy diagnostic performance following a pilot quality-assurance programme in health facilities in malaria low-transmission areas of Kenya, 2014. Malar J 16: 371.
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37.
Olukosi Y et al. 2015. Assessment of competence of participants before and after 7-day intensive malaria microscopy training courses in Nigeria. MWJ 6: 6.
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38.
Bates I, Bekoe V, Asamoa-Adu A, 2004. Improving the accuracy of malaria-related laboratory tests in Ghana. Malar J 3: 38.
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39.
Ngasala B, Mubi M, Warsame M, Petzold MG, Massele AY, Gustafsson LL, Tomson G, Premji Z, Bjorkman A, 2008. Impact of training in clinical and microscopy diagnosis of childhood malaria on antimalarial drug prescription and health outcome at primary health care level in Tanzania: a randomized controlled trial. Malar J 7: 199.
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40.
Sarkinfada F, Aliyu Y, Chavasse C, Bates I, 2009. Impact of introducing integrated quality assessment for tuberculosis and malaria microscopy in Kano, Nigeria. J Infect Dev Ctries 3: 20–27.
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Wanja E et al. 2017. Evaluation of a laboratory quality assurance pilot programme for malaria diagnostics in low-transmission areas of Kenya, 2013. Malar J 16: 221.
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42.
Wickham H, 2016. ggplot2: Elegant Graphics for Data Analysis. New York, NY: Springer-Verlag.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 365 | 300 | 92 |
| Full Text Views | 883 | 20 | 2 |
| PDF Downloads | 219 | 19 | 3 |
Performance Outcomes from Africa-Based Malaria Diagnostic Competency Assessment Courses
Matt Worges
Matt Worges
President’s Malaria Initiative (PMI) MalariaCare Project, Medical Care Development International, Silver Spring, Maryland;
Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana;
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Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana;
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Nicole Whitehurst
Nicole Whitehurst
President’s Malaria Initiative (PMI) MalariaCare Project, Medical Care Development International, Silver Spring, Maryland;
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Renion Saye
Renion Saye
President’s Malaria Initiative (PMI) MalariaCare Project, Medical Care Development International, Bamako, Mali;
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Daouda Ndiaye
Daouda Ndiaye
Cheikh Anta Diop University, Dakar, Senegal;
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Emanuel Yamo
Emanuel Yamo
President’s Malaria Initiative (PMI) MalariaCare Project, Medical Care Development International, Kisumu, Kenya;
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Joshua Yukich
Joshua Yukich
Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
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The U.S. President’s Malaria Initiative–funded MalariaCare project implemented an external quality assurance scheme to support malaria diagnostics and case management across a spectrum of health facilities in participating African countries. A component of this program was a 5-day, malaria diagnostic competency assessment (MDCA) course for health facility laboratory staff conducting malaria microscopy. The MDCA course provided a method to quantify participant skill levels in microscopic examination of malaria across three major diagnosis areas: parasite detection, species identification, and parasite quantification. A total of 817 central-, regional-, and peripheral-level microscopists from 45 MDCA courses across nine African countries were included in the analysis. Differences in mean scores with respect to daily marginal performance were positive and statistically significant (P < 0.001) for each challenge type across all participants combined. From pretest to assessment day 4, mean scores for parasite detection, species identification, and parasite quantification increased by 19.1, 34.9, and 38.2 percentage points, respectively. In addition, sensitivity and specificity increased by 20.8 and 13.8 percentage points, respectively, by assessment day 4. Furthermore, the ability of MDCA participants to accurately report Plasmodium falciparum species when present increased from 44.5% at pretest to 67.1% by assessment day 4. The MDCA course rapidly improved the microscopy performance of participants over a short period of time. Because of its rigor, the MDCA course could serve as a mechanism for measuring laboratory staff performance against country-specific minimum competency standards and could easily be adapted to serve as a national certification course.
Author Notes
Financial support: Financial support was provided by the U.S. President’s Malaria Initiative under the terms of Cooperative Agreement AID-OAA-A-12-00057.
Authors’ addresses: Matt Worges, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, E-mail: mworges@tulane.edu. Nicole Whitehurst, Medical Care Development International, Silver Spring, MD, E-mail: whitehurstnicole@yahoo.com. Renion Saye, Medical Care Development International, Bamako, Mali, E-mail: srenion@yahoo.fr. Daouda Ndiaye, Cheikh Anta Diop University, Dakar, Senegal, E-mail: daouda.ndiaye@ucad.edu.sn. Emanuel Yamo, Medical Care Development International, Kisumu, Kenya, E-mail: yamoouma@yahoo.com. Joshua Yukich, Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, E-mail: jyukich@tulane.edu.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization, 2011. Universal Access to Malaria Diagnostic Testing—An Operational Manual. Geneva, Switzerland: WHO.
-
2.
Molyneux M, Fox R, 1993. Diagnosis and treatment of malaria in Britain. BMJ 306: 1175–1180.
-
3.
Hanscheid T, 1999. Diagnosis of malaria: a review of alternatives to conventional microscopy. Clin Lab Haematol 21: 235–245.
-
4.
World Health Organization, 2016. Malaria Microscopy Quality Assurance Manual—Version 2. Geneva, Switzerland: WHO.
-
5.
Ashraf S, Kao A, Hugo C, Christophel EM, Fatunmbi B, Luchavez J, Lilley K, Bell D, 2012. Developing standards for malaria microscopy: external competency assessment for malaria microscopists in the Asia-Pacific. Malar J 11: 352.
-
6.
Bell D, Wongsrichanalai C, Barnwell JW, 2006. Ensuring quality and access for malaria diagnosis: how can it be achieved? Nat Rev Microbiol 4 (9 Suppl): S7–S20.
-
7.
World Health Organization, 2009. WHO Malaria Rapid Diagnostic Test Performance—Results of WHO Product Testing of Malaria RDTs: Round 2. Available at: www.who.int/malaria/publications/atoz/9789241599467/en/index.html. Accessed May 5, 2017.
-
8.
World Health Organization, 2015. Guidelines for the Treatment of Malaria, 3rd edition. Geneva, Switzerland: WHO.
-
9.
The malERA Consultative Group on Diagnoses and Diagnostics, 2011. A research agenda for malaria eradication: diagnoses and diagnostics. PLoS Med 8: e1000396.
-
10.
Amexo M, Tolhurst R, Barnish G, Bates I, 2004. Malaria misdiagnosis: effects on the poor and vulnerable. Lancet 364: 1896–1898.
-
11.
Coleman RE et al. 2006. Comparison of PCR and microscopy for the detection of asymptomatic malaria in a Plasmodium falciparum/vivax endemic area in Thailand. Malar J 5: 121.
-
12.
Zurovac D, Midia B, Ochola SA, English M, Snow RW, 2006. Microscopy and outpatient malaria case management among older children and adults in Kenya. Trop Med Int Health 11: 432–440.
-
13.
Ohrt C, Purnomo, Sutamihardja MA, Tang D, Kain KC, 2002. Impact of microscopy error on estimates of protective efficacy in malaria-prevention trials. J Infect Dis 186: 540–546.
-
14.
Wongsrichanalai C, Barcus MJ, Muth S, Sutamihardja A, Wernsdorfer WH, 2007. A review of malaria diagnostic tools: microscopy and rapid diagnostic test (RDT). Am J Trop Med Hyg 77 (Suppl 6): 119–127.
-
15.
Kahama-Maro J, D’Acremont V, Mtasiwa D, Genton B, Lengeler C, 2011. Low quality of routine microscopy for malaria at different levels of the health system in Dar es Salaam. Malar J 10: 332.
-
16.
Kachur SP, Nicolas E, Jean-François V, Benitez A, Bloland PB, Saint Jean Y, Mount DL, Ruebush TK 2nd, Nguyen-Dinh P, 1998. Prevalence of malaria parasitemia and accuracy of microscopic diagnosis in Haiti, October 1995. Rev Panam Salud Publica 3: 35–39.
-
17.
Durrheim DN, Becker PJ, Billinghurst K, 1997. Diagnostic disagreement—the lessons learnt from malaria diagnosis in Mpumalanga. S Afr Med J 87: 1016.
-
18.
Kain KC, Harrington MA, Tennyson S, Keystone JS, 1998. Imported malaria: prospective analysis of problems in diagnosis and management. Clin Infect Dis 27: 142–149.
-
19.
Kilian AH, Metzger WG, Mutschelknauss EJ, Kabagambe G, Langi P, Korte R, von Sonnenburg F, 2000. Reliability of malaria microscopy in epidemiological studies: results of quality control. Trop Med Int Health 5: 3–8.
-
20.
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: 141–144.
-
21.
O’Meara WP, McKenzie FE, Magill AJ, Forney JR, Permpanich B, Lucas C, Gasser RA Jr., Wongsrichanalai C, 2005. Sources of variability in determining malaria parasite density by microscopy. Am J Trop Med Hyg 73: 593–598.
-
22.
Gomes LT et al. 2013. Low sensitivity of malaria rapid diagnostic tests stored at room temperature in the Brazilian Amazon region. J Infect Dev Ctries 7: 243–252.
-
23.
Bell D, Perkins MD, 2008. Making malaria testing relevant: beyond test purchase. Trans R Soc Trop Med Hyg 102: 1064–1066.
-
24.
Mwangi TW, Mohammed M, Dayo H, Snow RW, Marsh K, 2005. Clinical algorithms for malaria diagnosis lack utility among people of different age groups. Trop Med Int Health 10: 530–536.
-
25.
Ochola LB, Vounatsou P, Smith T, Mabaso MLH, Newton C, 2006. The reliability of diagnostic techniques in the diagnosis and management of malaria in the absence of a gold standard. Lancet Infect Dis 6: 582–588.
-
26.
Barat L, Chipipa J, Kolczak M, Sukwa T, 1999. Does the availability of blood slide microscopy for malaria at health centers improve the management of persons with fever in Zambia? Am J Trop Med Hyg 60: 1024–1030.
-
27.
Reyburn H et al. 2004. Overdiagnosis of malaria in patients with severe febrile illness in Tanzania: a prospective study. BMJ 329: 1212.
-
28.
McMorrow ML, Masanja MI, Abdulla SM, Kahigwa E, Kachur SP, 2008. Challenges in routine implementation and quality control of rapid diagnostic tests for malaria—Rufiji District, Tanzania. Am J Trop Med Hyg 79: 385–390.
-
29.
Perkins BA et al. 1997. Evaluation of an algorithm for integrated management of childhood illness in an area of Kenya with high malaria transmission. Bull World Health Organ 75 (Suppl 1): 33–42.
-
30.
Evans JA, Adusei A, Timmann C, May J, Mack D, Agbenyega T, Horstmann RD, Frimpong E, 2004. High mortality of infant bacteraemia clinically indistinguishable from severe malaria. QJM 97: 591–597.
-
31.
Nateghpour M, Edrissian G, Raeisi A, Motevalli-Haghi A, Farivar L, Mohseni G, Rahimi-Froushani A, 2012. The role of malaria microscopy training and refresher training courses in malaria control program in Iran during 2001–2011. Iran J Parasitol 7: 104–109.
-
32.
Namagembe A et al. 2011. Improved clinical and laboratory skills after team-based, malaria case management training of health care professionals in Uganda. Malar J 11: 44.
-
33.
Kiggundu M, Nsobya SL, Kamya MR, Filler S, Nasr S, Dorsey D, Yeka A, 2011. Evaluation of a comprehensive refresher training program in malaria microscopy covering four districts of Uganda. Am J Trop Med Hyg 84: 820–824.
-
34.
Moura S, Fançony C, Mirante C, Neves M, Bernardino L, Fortes F, Sambo MR, Brito M, 2014. Impact of a training course on the quality of malaria diagnosis by microscopy in Angola. Malar J 13: 437.
-
35.
Aiyenigba B, Ojo A, Aisiri A, Uzim J, Adeusi O, Mwenesi H, 2017. Immediate assessment of performance of medical laboratory scientists following a 10-day malaria microscopy training programme in Nigeria. Glob Health Res Policy 2: 32.
-
36.
Odhiambo F et al. 2017. Factors associated with malaria microscopy diagnostic performance following a pilot quality-assurance programme in health facilities in malaria low-transmission areas of Kenya, 2014. Malar J 16: 371.
-
37.
Olukosi Y et al. 2015. Assessment of competence of participants before and after 7-day intensive malaria microscopy training courses in Nigeria. MWJ 6: 6.
-
38.
Bates I, Bekoe V, Asamoa-Adu A, 2004. Improving the accuracy of malaria-related laboratory tests in Ghana. Malar J 3: 38.
-
39.
Ngasala B, Mubi M, Warsame M, Petzold MG, Massele AY, Gustafsson LL, Tomson G, Premji Z, Bjorkman A, 2008. Impact of training in clinical and microscopy diagnosis of childhood malaria on antimalarial drug prescription and health outcome at primary health care level in Tanzania: a randomized controlled trial. Malar J 7: 199.
-
40.
Sarkinfada F, Aliyu Y, Chavasse C, Bates I, 2009. Impact of introducing integrated quality assessment for tuberculosis and malaria microscopy in Kano, Nigeria. J Infect Dev Ctries 3: 20–27.
-
41.
Wanja E et al. 2017. Evaluation of a laboratory quality assurance pilot programme for malaria diagnostics in low-transmission areas of Kenya, 2013. Malar J 16: 221.
-
42.
Wickham H, 2016. ggplot2: Elegant Graphics for Data Analysis. New York, NY: Springer-Verlag.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 365 | 300 | 92 |
| Full Text Views | 883 | 20 | 2 |
| PDF Downloads | 219 | 19 | 3 |