Abstract:
External quality assessment (EQA) is an alternative tool to cross-checking of blood slides in the quality control of malaria microscopy. This study reports the findings of an EQA of malaria microscopy in El Obeid City North Kordofan. For each medical laboratory under study, we distributed a well designed questionnaire plus five blood films (two negative and three positive films with different parasitaemia; low, moderate and high parasitaemia). We collected two slides stained & unstained blood films as well as 1 ml of Geimsa stain from each lab.
A total of 76 laboratories (55% private vs. 45% public) were participated in the study. The study found that most of laboratories are using Geimsa, but the IQC and EQA for both staff and stain demonstrated poor performance. Although only 20% have a record for malaria results. Half of laboratories reporting only whether the parasite identified or not. When studying the quality of BF; 75% are using thick blood film with acceptable quality for staining process and good for stain. The obtained results of the five blood films were; clear negative are answered correct (61%), negative with artifacts (49%), but the three positive slides were answered correctly as flows; low 49%, moderate 76% and high parasite 59%. The major errors include; not reporting the density of malaria low (50%), moderate (31%) and high parasite (13%), but those reporting wrong were low (24%), moderate (39%) and high parasite (24%). The study concluded that, the performance of medical laboratories in El Obeid in microscopical examinations for malaria parasite were acceptable, but further training courses and effective quality assurance scheme are needed.
