Impact of Horizontal Approach in Vertical Program: Continuous Quality Improvement of Malaria and Tuberculosis Diagnostic Services at Primary-Level Medical Laboratories in the Context of HIV Care and Treatment Program in Ethiopia

Francesco Marinucci Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland; Institute of Human Virology, University of Maryland, US President's Emergency Plan for AIDS Relief, Addis Ababa, Ethiopia

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Tsegahun Manyazewal Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland; Institute of Human Virology, University of Maryland, US President's Emergency Plan for AIDS Relief, Addis Ababa, Ethiopia

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Antonio D. Paterniti Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland; Institute of Human Virology, University of Maryland, US President's Emergency Plan for AIDS Relief, Addis Ababa, Ethiopia

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Sandra Medina-Moreno Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland; Institute of Human Virology, University of Maryland, US President's Emergency Plan for AIDS Relief, Addis Ababa, Ethiopia

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Matthew Wattleworth Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland; Institute of Human Virology, University of Maryland, US President's Emergency Plan for AIDS Relief, Addis Ababa, Ethiopia

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Juliana Hagembe Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland; Institute of Human Virology, University of Maryland, US President's Emergency Plan for AIDS Relief, Addis Ababa, Ethiopia

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Robert R. Redfield Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland; Institute of Human Virology, University of Maryland, US President's Emergency Plan for AIDS Relief, Addis Ababa, Ethiopia

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The use of standardized tools for continuous quality improvement of laboratory services is crucial to identify service gaps, plan targeted interventions, and prove successes. Laboratory quality improvement tools (LQITs) were developed and applied for 18 months at five health centers and one faith-based hospital laboratories in Southwest Showa Zone in Ethiopia to assess and monitor the quality of malaria and acid-fast bacilli (AFB) microscopy total testing processes. For the six laboratories, baseline malaria microscopy scores were 55%, 42%, 52%, 55%, 54%, and 61%. Similarly, baseline AFB microscopy scores were 49%, 41%, 46%, 58%, 44%, and 70%. On the sixth quarter for the first four laboratories and the fourth quarter for the last two laboratories, malaria microscopy scores were 89%, 88%, 88%, 90%, 88%, and 89%, whereas AFB microscopy scores were 90%, 88%, 89%, 95%, 88%, and 90%. All laboratories scored above 85% for both services at the end of interventions.

Author Notes

* Address correspondence to Tsegahun Manyazewal, Institute of Human Virology, University of Maryland, US President's Emergency Plan for AIDS Relief, PO Box 2454, Addis Ababa, Ethiopia. E-mail: tsegahunm@gmail.com

Authors' addresses: Francesco Marinucci, Antonio D. Paterniti, Sandra Medina-Moreno, Matthew Wattleworth, Juliana Hagembe, and Robert R. Redfield, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, E-mails: fmarinucci@ihv.umaryland.edu, apaterniti@ihv.umaryland.edu, smmoreno@ihv.umaryland.edu, mwattleworth@ihv.umaryland.edu, jhagembe@ihv.umaryland.edu, and rredfield@ihv.umaryland.edu. Tsegahun Manyazewal, Institute of Human Virology, University of Maryland, US President's Emergency Plan for AIDS Relief, Addis Ababa, Ethiopia, E-mail: tsegahunm@gmail.com.

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