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External quality assessment of Giemsa-stained blood film microscopy for the diagnosis of malaria and sleeping sickness in the Democratic Republic of the Congo

MUKADI, Pierre ; GILLET, Philippe ; MUYEMBE, Jean-Jacques ; JACOBS, Jan ; LEJON, Veerle ; LUKUKA, Albert ; ATUA, Benjamin ; SHESHE, Nicole ; KANZA, Albert ; BOSCO MAYUNDA, Jean ; MONGITA, Briston ; SENGA, Raphaël ; NGOYI, John

Bulletin of the World Health Organization, 2013-06, Vol.91 (6), p.441-448 [Periódico revisado por pares]

Genève: Organisation mondiale de la santé

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Título:
External quality assessment of Giemsa-stained blood film microscopy for the diagnosis of malaria and sleeping sickness in the Democratic Republic of the Congo
Autor: MUKADI, Pierre ; GILLET, Philippe ; MUYEMBE, Jean-Jacques ; JACOBS, Jan ; LEJON, Veerle ; LUKUKA, Albert ; ATUA, Benjamin ; SHESHE, Nicole ; KANZA, Albert ; BOSCO MAYUNDA, Jean ; MONGITA, Briston ; SENGA, Raphaël ; NGOYI, John
Assuntos: Adolescent ; Adult ; Azure Stains ; Biological and medical sciences ; Blood ; Coloring Agents ; Democratic Republic of Congo ; Democratic Republic of the Congo ; Density ; Diagnostic Errors - prevention & control ; Diagnostic Errors - statistics & numerical data ; Diagnostic tests ; Diseases ; Errors ; Evaluation ; Gametocytes ; General aspects ; Health facilities ; Health Policy & Services ; Human protozoal diseases ; Humans ; Illness ; Infectious diseases ; Laboratories ; Laboratories - standards ; Laboratories - statistics & numerical data ; Malaria ; Malaria - diagnosis ; Medical sciences ; Microscopy ; Miscellaneous ; Parasites ; Parasitic diseases ; Plasmodium falciparum ; Plasmodium falciparum - isolation & purification ; Protozoa ; Protozoal diseases ; Provinces ; Public health ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Public officials ; Quality assessment ; Quality Assurance, Health Care - methods ; Studies ; Trends ; Trypanosoma brucei ; Trypanosoma brucei brucei - isolation & purification ; Trypanosomiasis, African - diagnosis ; World Health Organization ; Young Adult
É parte de: Bulletin of the World Health Organization, 2013-06, Vol.91 (6), p.441-448
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: To report the findings of a second external quality assessment of Giemsa-stained blood film microscopy in the Democratic Republic of the Congo, performed one year after the first. A panel of four slides was delivered to diagnostic laboratories in all provinces of the country. The slides contained: (i) Plasmodium falciparum gametocytes; (ii) P. falciparum trophozoites (reference density: 113,530 per µl); (iii) Trypanosoma brucei subspecies; and (iv) no parasites. Of 356 laboratories contacted, 277 (77.8%) responded. Overall, 35.0% of the laboratories reported all four slides correctly but 14.1% reported correct results for 1 or 0 slides. Major errors included not diagnosing trypanosomiasis (50.4%), not recognizing P. falciparum gametocytes (17.5%) and diagnosing malaria from the slide with no parasites (19.0%). The frequency of serious errors in assessing parasite density and in reporting false-positive results was lower than in the previous external quality assessment: 17.2% and 52.3%, respectively, (P < 0.001) for parasite density and 19.0% and 33.3%, respectively, (P < 0.001) for false-positive results. Laboratories that participated in the previous quality assessment performed better than first-time participants and laboratories in provinces with a high number of sleeping sickness cases recognized trypanosomes more frequently (57.0% versus 31.2%, P < 0.001). Malaria rapid diagnostic tests were used by 44.3% of laboratories, almost double the proportion observed in the previous quality assessment. The overall quality of blood film microscopy was poor but was improved by participation in external quality assessments. The failure to recognize trypanosomes in a country where sleeping sickness is endemic is a concern.
Editor: Genève: Organisation mondiale de la santé
Idioma: Inglês;Português

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External quality assessment of Giemsa-stained blood film microscopy for the diagnosis of malaria and sleeping sickness in the Democratic Republic of the Congo

MUKADI, Pierre ; GILLET, Philippe ; MUYEMBE, Jean-Jacques ; JACOBS, Jan ; LEJON, Veerle ; LUKUKA, Albert ; ATUA, Benjamin ; SHESHE, Nicole ; KANZA, Albert ; BOSCO MAYUNDA, Jean ; MONGITA, Briston ; SENGA, Raphaël ; NGOYI, John

Genève: Organisation mondiale de la santé

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