World Health Organization, 2010. Guidelines for the Treatment of Malaria. Geneva, Switzerland: World Health Organization.
Bell D, Perkins MD, 2008. Making malaria testing relevant: beyond test purchase. Trans R Soc Trop Med Hyg 102: 1064–1066.
Molyneux M, Fox R, 1993. Diagnosis and treatment of malaria in Britain. BMJ 306: 1175–1180.
Bates I, Bekoe V, Asamoa-Adu A, 2004. Improving the accuracy of malaria-related laboratory tests in Ghana. Malar J 3: 38.
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.
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.
Ssekabira U, Bukirwa H, Hopkins H, Namagembe A, Weaver MR, Sebuyira LM, Quick L, Staedke S, Yeka A, Kiggundu M, Schneider G, McAdam K, Wabwire-Mangen F, Dorsey G, 2008. Improved malaria case management after integrated team-based training of health care workers in Uganda. Am J Trop Med Hyg 79: 826–833.
Okello PE, Van Bortel W, Byaruhanga AM, Correwyn A, Roelants P, Talisuna A, D'Alessandro U, Coosemans M, 2006. Variation in malaria transmission intensity in seven sites throughout Uganda. Am J Trop Med Hyg 75: 219–225.
World Health Organization, 2006. World Malaria Report. Geneva, Switzerland: World Health Organization.
Durrheim DN, Becker PJ, Billinghurst K, 1997. Diagnostic disagreement—the lessons learnt from malaria diagnosis in Mpumalanga. S Afr Med J 87: 609–611.
Kachur SP, Nicolas E, Jean-Francois 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.
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.
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.
Payne D, 1988. Use and limitations of light microscopy for diagnosing malaria at the primary health care level. Bull World Health Organ 66: 621–626.
Hopkins H, Asiimwe C, Bell D, 2009. Access to antimalarial therapy: accurate diagnosis is essential to achieving long term goals. BMJ 339: b2606.
Barnish G, Bates I, Iboro J, 2004. Newer drug combinations for malaria. BMJ 328: 1511–1512.
Nosten F, Ashley E, 2004. The detection and treatment of Plasmodium falciparum malaria: time for change. J Postgrad Med 50: 35–39.
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.
Reyburn H, Ruanda J, Mwerinde O, Drakeley C, 2006. The contribution of microscopy to targeting antimalarial treatment in a low transmission area of Tanzania. Malar J 5: 4.
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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.
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.