Cargando…
Mentorship on malaria microscopy diagnostic service in Ethiopia: baseline competency of microscopists and performance of health facilities
BACKGROUND: In Ethiopia, malaria cases are declining as a result of proven interventions, and in 2017 the country launched a malaria elimination strategy in targeted settings. Accurate malaria diagnosis and prompt treatment are the key components of the strategy to prevent morbidity and stop the con...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908686/ https://www.ncbi.nlm.nih.gov/pubmed/33632208 http://dx.doi.org/10.1186/s12936-021-03655-9 |
_version_ | 1783655770014875648 |
---|---|
author | Gidey, Bokretsion Nega, Desalegn Abera, Adugna Abebe, Abnet Mekasha, Sindew Tasew, Geremew Haile, Mebrahtom Dillu, Dereje Mehari, Degu Assefa, Ashenafi Liknew, Wondimeneh G/Tsadik, Abeba Mohammed, Hussien Woldie, Ermias Getachew, Tsegaye Ararso, Desalegn Yenealem, Dereje Kebede, Adisu Etana, Kebede Kedida, Gizachew Solomon, Hiwot Tollera, Getachew Woyessa, Adugna Abate, Ebba |
author_facet | Gidey, Bokretsion Nega, Desalegn Abera, Adugna Abebe, Abnet Mekasha, Sindew Tasew, Geremew Haile, Mebrahtom Dillu, Dereje Mehari, Degu Assefa, Ashenafi Liknew, Wondimeneh G/Tsadik, Abeba Mohammed, Hussien Woldie, Ermias Getachew, Tsegaye Ararso, Desalegn Yenealem, Dereje Kebede, Adisu Etana, Kebede Kedida, Gizachew Solomon, Hiwot Tollera, Getachew Woyessa, Adugna Abate, Ebba |
author_sort | Gidey, Bokretsion |
collection | PubMed |
description | BACKGROUND: In Ethiopia, malaria cases are declining as a result of proven interventions, and in 2017 the country launched a malaria elimination strategy in targeted settings. Accurate malaria diagnosis and prompt treatment are the key components of the strategy to prevent morbidity and stop the continuation of transmission. However, the quality of microscopic diagnosis in general is deteriorating as malaria burden declines. This study was carried out to evaluate the competency of microscopists and the performance of health facilities on malaria microscopic diagnosis. METHODS: A cross-sectional study was conducted from 1 August to 30 September, 2019 in 9 regional states and one city administration. A standard checklist was used for on-site evaluation, archived patient slides were re-checked and proficiency of microscopists was tested using a WHO-certified set of slides from the national slide bank at the Ethiopian Public Health Institute (EPHI). The strength of agreement, sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS: In this study, 102 health facilities (84 health centres and 18 hospitals) were included, from which 202 laboratory professionals participated. In slide re-checking, moderate agreement (agreement (A): 76.0%; Kappa (K): 0.41) was observed between experts and microscopists on malaria detection in all health facilities. The sensitivity and specificity of routine slide reading and the re-checking results were 78.1 and 80.7%, respectively. Likewise, positive predictive value of 65.1% and negative predictive value of 88.8% were scored in the routine diagnosis. By panel testing, a substantial overall agreement (A: 91.8%; K: 0.79) was observed between microscopists and experts in detecting malaria parasites. The sensitivity and specificity in the detection of malaria parasites was 92.7 and 89.1%, respectively. In identifying species, a slight agreement (A: 57%; K: 0.18) was observed between microscopists and experts. CONCLUSION: The study found significant false positive and false negative results in routine microscopy on slide re-checking of Plasmodium parasites. Moreover, reduced grade in parasite species identification was reported on the panel tests. Implementing comprehensive malaria microscopy mentorship, in-service training and supportive supervision are key strategies to improve the overall performance of health facilities in malaria microscopy. |
format | Online Article Text |
id | pubmed-7908686 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-79086862021-02-26 Mentorship on malaria microscopy diagnostic service in Ethiopia: baseline competency of microscopists and performance of health facilities Gidey, Bokretsion Nega, Desalegn Abera, Adugna Abebe, Abnet Mekasha, Sindew Tasew, Geremew Haile, Mebrahtom Dillu, Dereje Mehari, Degu Assefa, Ashenafi Liknew, Wondimeneh G/Tsadik, Abeba Mohammed, Hussien Woldie, Ermias Getachew, Tsegaye Ararso, Desalegn Yenealem, Dereje Kebede, Adisu Etana, Kebede Kedida, Gizachew Solomon, Hiwot Tollera, Getachew Woyessa, Adugna Abate, Ebba Malar J Research BACKGROUND: In Ethiopia, malaria cases are declining as a result of proven interventions, and in 2017 the country launched a malaria elimination strategy in targeted settings. Accurate malaria diagnosis and prompt treatment are the key components of the strategy to prevent morbidity and stop the continuation of transmission. However, the quality of microscopic diagnosis in general is deteriorating as malaria burden declines. This study was carried out to evaluate the competency of microscopists and the performance of health facilities on malaria microscopic diagnosis. METHODS: A cross-sectional study was conducted from 1 August to 30 September, 2019 in 9 regional states and one city administration. A standard checklist was used for on-site evaluation, archived patient slides were re-checked and proficiency of microscopists was tested using a WHO-certified set of slides from the national slide bank at the Ethiopian Public Health Institute (EPHI). The strength of agreement, sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS: In this study, 102 health facilities (84 health centres and 18 hospitals) were included, from which 202 laboratory professionals participated. In slide re-checking, moderate agreement (agreement (A): 76.0%; Kappa (K): 0.41) was observed between experts and microscopists on malaria detection in all health facilities. The sensitivity and specificity of routine slide reading and the re-checking results were 78.1 and 80.7%, respectively. Likewise, positive predictive value of 65.1% and negative predictive value of 88.8% were scored in the routine diagnosis. By panel testing, a substantial overall agreement (A: 91.8%; K: 0.79) was observed between microscopists and experts in detecting malaria parasites. The sensitivity and specificity in the detection of malaria parasites was 92.7 and 89.1%, respectively. In identifying species, a slight agreement (A: 57%; K: 0.18) was observed between microscopists and experts. CONCLUSION: The study found significant false positive and false negative results in routine microscopy on slide re-checking of Plasmodium parasites. Moreover, reduced grade in parasite species identification was reported on the panel tests. Implementing comprehensive malaria microscopy mentorship, in-service training and supportive supervision are key strategies to improve the overall performance of health facilities in malaria microscopy. BioMed Central 2021-02-25 /pmc/articles/PMC7908686/ /pubmed/33632208 http://dx.doi.org/10.1186/s12936-021-03655-9 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Gidey, Bokretsion Nega, Desalegn Abera, Adugna Abebe, Abnet Mekasha, Sindew Tasew, Geremew Haile, Mebrahtom Dillu, Dereje Mehari, Degu Assefa, Ashenafi Liknew, Wondimeneh G/Tsadik, Abeba Mohammed, Hussien Woldie, Ermias Getachew, Tsegaye Ararso, Desalegn Yenealem, Dereje Kebede, Adisu Etana, Kebede Kedida, Gizachew Solomon, Hiwot Tollera, Getachew Woyessa, Adugna Abate, Ebba Mentorship on malaria microscopy diagnostic service in Ethiopia: baseline competency of microscopists and performance of health facilities |
title | Mentorship on malaria microscopy diagnostic service in Ethiopia: baseline competency of microscopists and performance of health facilities |
title_full | Mentorship on malaria microscopy diagnostic service in Ethiopia: baseline competency of microscopists and performance of health facilities |
title_fullStr | Mentorship on malaria microscopy diagnostic service in Ethiopia: baseline competency of microscopists and performance of health facilities |
title_full_unstemmed | Mentorship on malaria microscopy diagnostic service in Ethiopia: baseline competency of microscopists and performance of health facilities |
title_short | Mentorship on malaria microscopy diagnostic service in Ethiopia: baseline competency of microscopists and performance of health facilities |
title_sort | mentorship on malaria microscopy diagnostic service in ethiopia: baseline competency of microscopists and performance of health facilities |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908686/ https://www.ncbi.nlm.nih.gov/pubmed/33632208 http://dx.doi.org/10.1186/s12936-021-03655-9 |
work_keys_str_mv | AT gideybokretsion mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT negadesalegn mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT aberaadugna mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT abebeabnet mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT mekashasindew mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT tasewgeremew mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT hailemebrahtom mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT dilludereje mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT meharidegu mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT assefaashenafi mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT liknewwondimeneh mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT gtsadikabeba mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT mohammedhussien mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT woldieermias mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT getachewtsegaye mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT ararsodesalegn mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT yenealemdereje mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT kebedeadisu mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT etanakebede mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT kedidagizachew mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT solomonhiwot mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT tolleragetachew mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT woyessaadugna mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities AT abateebba mentorshiponmalariamicroscopydiagnosticserviceinethiopiabaselinecompetencyofmicroscopistsandperformanceofhealthfacilities |