External Quality Assessment: Microscopy Diagnosis of Plasmodium falciparum for a Better Management of Malaria in the Regional Health Center in Côte d’Ivoire

Abstract

Context: In Côte d'Ivoire, malaria is transmitted throughout the year with an increased rate during the rainy season. This pathology is endemic on the whole territory with seasonal variations. The major vector is Anopheles gambiae. The external microbiology quality assessment programs organized by both Institut Pasteur of Côte d'Ivoire (IPCI) and PEPFAR, malaria microscopy was randomly carried out in 1/3 of the country regional health center laboratories.  Laboratory technicians play a key role in malaria control programs because care services such as the disease monitoring depend on their diagnosis and technical skills. Aim: The aim of this evaluation was to control the quality of the microscopic diagnosis and the performance of on-duty technicians for the management of feverish patients and efforts to strengthen laboratory services. Méthodology: Six (6) RHC (Regional Health Center) laboratories were involved in the evaluation. Anonymity code was assigned to each of the participating laboratories. There were many discrepancies in External Quality Assessment (EQA) results on the field not with standing the parasitemia, low or high. Results: Only 30% of correct answers were recorded for P. falciparum identification. For P. ovale, we found a failure rate of 100% for laboratories. Conclusion: Parasitemia was approximate and many confusions were observed regarding the different stages of parasites.