Impact of a training course on the quality of malaria diagnosis by microscopy in Angola

Sofia Moura, Cláudia Fançony, Clara Mirante, Marcela Neves, Luís Bernardino, Filomeno Fortes, Maria Do Rosário Sambo, Miguel Brito

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: In Angola, malaria is an endemic disease having a major impact on the economy. The WHO recommends testing for all suspected malaria cases, to avoid the presumptive treatment of this disease. In malaria endemic regions laboratory technicians must be very comfortable with microscopy, the golden standard for malaria diagnosis, to avoid the incorrect diagnosis. The improper use of medication promotes drug resistance and undesirable side effects. The present study aims to assess the impact of a three-day refresher course on the knowledge of technicians, quality of blood smears preparation and accuracy of microscopy malaria diagnosis, using qPCR as reference method. Methods: This study was implemented in laboratories from three hospitals in different provinces of Angola: Bengo, Benguela and Luanda. In each laboratory samples were collected before and after the training course (slide with thin and thick blood smears, a dried blood spot and a form). The impact of the intervention was evaluated through a written test, the quality of slide preparation and the performance of microscopy. Results: It was found a significant increase on the written test median score, from 52.5% to 65.0%. A total of 973 slides were analysed to evaluate the quality of thick and thin blood smears. Considering all laboratories there was a significant increase in quality of thick and thin blood smears. To determine the performance of microscopy using qPCR as the reference method we used 1,028 samples. Benguela presented the highest values for specificity, 92.9% and 98.8% pre and post-course, respectively and for sensitivity the best pre-course was Benguela (75.9%) and post-course Luanda (75.0%). However, no significant increase in sensitivity and specificity after the training course was registered in any laboratory analysed. Discussion: The findings of this study support the need of continuous refresher training for microscopists and other laboratory staff. The laboratories should have a quality control programme to supervise the diagnosis and also to assess the periodicity of new training. However, other variables needed to be considered to have a correct malaria diagnosis, such as adequate equipment and reagents for staining and visualization, good working conditions, motivated and qualified personnel.

Original languageEnglish
Article number437
JournalMalaria Journal
Volume13
Issue number1
DOIs
Publication statusPublished - 2014

Fingerprint

Angola
Malaria
Microscopy
Laboratory Personnel
Endemic Diseases
Hospital Laboratories
Periodicity
Drug Resistance
Quality Control
Staining and Labeling
Sensitivity and Specificity
Equipment and Supplies

Keywords

  • Angola
  • Impact
  • Malaria
  • Microscopy
  • Quality
  • Training

Cite this

Moura, S., Fançony, C., Mirante, C., Neves, M., Bernardino, L., Fortes, F., ... Brito, M. (2014). Impact of a training course on the quality of malaria diagnosis by microscopy in Angola. Malaria Journal, 13(1), [437]. https://doi.org/10.1186/1475-2875-13-437
Moura, Sofia ; Fançony, Cláudia ; Mirante, Clara ; Neves, Marcela ; Bernardino, Luís ; Fortes, Filomeno ; Sambo, Maria Do Rosário ; Brito, Miguel. / Impact of a training course on the quality of malaria diagnosis by microscopy in Angola. In: Malaria Journal. 2014 ; Vol. 13, No. 1.
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Moura, S, Fançony, C, Mirante, C, Neves, M, Bernardino, L, Fortes, F, Sambo, MDR & Brito, M 2014, 'Impact of a training course on the quality of malaria diagnosis by microscopy in Angola', Malaria Journal, vol. 13, no. 1, 437. https://doi.org/10.1186/1475-2875-13-437

Impact of a training course on the quality of malaria diagnosis by microscopy in Angola. / Moura, Sofia; Fançony, Cláudia; Mirante, Clara; Neves, Marcela; Bernardino, Luís; Fortes, Filomeno; Sambo, Maria Do Rosário; Brito, Miguel.

In: Malaria Journal, Vol. 13, No. 1, 437, 2014.

Research output: Contribution to journalArticle

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T1 - Impact of a training course on the quality of malaria diagnosis by microscopy in Angola

AU - Moura, Sofia

AU - Fançony, Cláudia

AU - Mirante, Clara

AU - Neves, Marcela

AU - Bernardino, Luís

AU - Fortes, Filomeno

AU - Sambo, Maria Do Rosário

AU - Brito, Miguel

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PY - 2014

Y1 - 2014

N2 - Background: In Angola, malaria is an endemic disease having a major impact on the economy. The WHO recommends testing for all suspected malaria cases, to avoid the presumptive treatment of this disease. In malaria endemic regions laboratory technicians must be very comfortable with microscopy, the golden standard for malaria diagnosis, to avoid the incorrect diagnosis. The improper use of medication promotes drug resistance and undesirable side effects. The present study aims to assess the impact of a three-day refresher course on the knowledge of technicians, quality of blood smears preparation and accuracy of microscopy malaria diagnosis, using qPCR as reference method. Methods: This study was implemented in laboratories from three hospitals in different provinces of Angola: Bengo, Benguela and Luanda. In each laboratory samples were collected before and after the training course (slide with thin and thick blood smears, a dried blood spot and a form). The impact of the intervention was evaluated through a written test, the quality of slide preparation and the performance of microscopy. Results: It was found a significant increase on the written test median score, from 52.5% to 65.0%. A total of 973 slides were analysed to evaluate the quality of thick and thin blood smears. Considering all laboratories there was a significant increase in quality of thick and thin blood smears. To determine the performance of microscopy using qPCR as the reference method we used 1,028 samples. Benguela presented the highest values for specificity, 92.9% and 98.8% pre and post-course, respectively and for sensitivity the best pre-course was Benguela (75.9%) and post-course Luanda (75.0%). However, no significant increase in sensitivity and specificity after the training course was registered in any laboratory analysed. Discussion: The findings of this study support the need of continuous refresher training for microscopists and other laboratory staff. The laboratories should have a quality control programme to supervise the diagnosis and also to assess the periodicity of new training. However, other variables needed to be considered to have a correct malaria diagnosis, such as adequate equipment and reagents for staining and visualization, good working conditions, motivated and qualified personnel.

AB - Background: In Angola, malaria is an endemic disease having a major impact on the economy. The WHO recommends testing for all suspected malaria cases, to avoid the presumptive treatment of this disease. In malaria endemic regions laboratory technicians must be very comfortable with microscopy, the golden standard for malaria diagnosis, to avoid the incorrect diagnosis. The improper use of medication promotes drug resistance and undesirable side effects. The present study aims to assess the impact of a three-day refresher course on the knowledge of technicians, quality of blood smears preparation and accuracy of microscopy malaria diagnosis, using qPCR as reference method. Methods: This study was implemented in laboratories from three hospitals in different provinces of Angola: Bengo, Benguela and Luanda. In each laboratory samples were collected before and after the training course (slide with thin and thick blood smears, a dried blood spot and a form). The impact of the intervention was evaluated through a written test, the quality of slide preparation and the performance of microscopy. Results: It was found a significant increase on the written test median score, from 52.5% to 65.0%. A total of 973 slides were analysed to evaluate the quality of thick and thin blood smears. Considering all laboratories there was a significant increase in quality of thick and thin blood smears. To determine the performance of microscopy using qPCR as the reference method we used 1,028 samples. Benguela presented the highest values for specificity, 92.9% and 98.8% pre and post-course, respectively and for sensitivity the best pre-course was Benguela (75.9%) and post-course Luanda (75.0%). However, no significant increase in sensitivity and specificity after the training course was registered in any laboratory analysed. Discussion: The findings of this study support the need of continuous refresher training for microscopists and other laboratory staff. The laboratories should have a quality control programme to supervise the diagnosis and also to assess the periodicity of new training. However, other variables needed to be considered to have a correct malaria diagnosis, such as adequate equipment and reagents for staining and visualization, good working conditions, motivated and qualified personnel.

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KW - Impact

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KW - Quality

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