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Evaluation of a Comprehensive Refresher Training Program in Malaria Microscopy Covering Four Districts of Uganda

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  • Department of Medicine, Makerere University Medical School, Kampala, Uganda; Malaria Branch, Centers for Diseases and Prevention, Atlanta, Georgia; Department of Medicine, University of California, San Francisco, California; Uganda Malaria Surveillance Program, Mulago Hospital Complex, Kampala, Uganda
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Microscopy remains the gold standard for malaria diagnosis. However, quality microscopy services are severely lacking in most African countries. To improve capacity for malaria microscopy in Uganda, a 3-day refresher training program was conducted in four districts. Training impact was measured through a written examination and evaluation of the quality of blood-slide preparation and accuracy of field microscopy. A total of 184 of 192 (96%) identified laboratory personnel participated in the training. Average test scores improved from 41% to 75% (P < 0.001). A total of 1,079 and 1,190 routinely made thick blood smears were collected before and after the training, respectively. Sensitivity improved from 84% to 95% (P < 0.001), and specificity improved from 87% to 97% (P < 0.001). The proportion of well-prepared blood smears improved from 6% to 75% (P < 0.001). Supplemental training can have a significant impact on the knowledge of staff, accuracy of microscopy, and quality of blood-slide preparation.

Author Notes

*Address correspondence to Adoke Yeka, Uganda Malaria Surveillance Program, PO Box 7475, Kampala, Uganda. E-mail: yadoke@muucsf.org

Financial support: This study received financial support from the President's Malaria Initiative through a cooperative agreement with the Centers for Disease Control and Prevention (U50/CCU925122).

Authors' addresses: Moses Kiggundu, Uganda Malaria Surveillance Program, Mulago Hospital Complex, Kampala, Uganda, E-mail: mkiggundu@muucsf.org. Samuel L. Nsobya, Uganda Malaria Surveillance Program, Mulago Hospital Complex, Kampala, Uganda, E-mail: samnsobya@yahoo.co.uk. Moses R. Kamya, Makerere University, University of California San Francisco, Malaria Research Collaboration, Kampala, Uganda, E-mail: mkamya@nfocom.co.ug. Scott Filler, Malaria Branch, Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, GA, E-mail: SFiller@cdc.gov. Sussan Nasr, Centers for Disease Control and Prevention, President's Malaria Initiative, Kampala, Uganda, E-mail: icz1@cdc.gov. Grant Dorsey, University of California, San Francisco, CA, E-mail: gdorsey@medsfgh.ucsf.edu. Adoke Yeka, Uganda Malaria Surveillance Program, Mulago Hospital Complex, Kampala, Uganda, E-mail: yadoke@muucsf.org.

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