Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.21/4739
Título: Impact of a training course on the quality of malaria diagnosis by microscopy in Angola
Autor: Moura, Sofia
Fançony, Cláudia
Mirante, Clara
Neves, Marcela
Bernardino, Luís
Fortes, Filomeno
Sambo, Maria do Rosário
Brito, Miguel
Palavras-chave: Malaria
Training
Microscopy
Quality
Professional competence
Laboratory personnel
Hospital
Angola
Data: Nov-2014
Editora: BioMed Central
Citação: Moura S, Fançony C, Mirante C, Neves M, Bernardino L, Brito M, et al. Impact of a training course on the quality of malaria diagnosis by microscopy in Angola. Malar J. 2014;13:437.
Resumo: 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.
Peer review: yes
URI: http://hdl.handle.net/10400.21/4739
DOI: 10.1186/1475-2875-13-437
Versão do Editor: http://www.malariajournal.com/content/13/1/437
Aparece nas colecções:ESTeSL - Artigos

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