Kettelhut M M, Chiodini P L, Edwards H, Moody A
UKNEQAS Parasitology, Department of Clinical Parasitology, Hospital for Tropical Diseases, Mortimer Market, Capper Street, London WC1E 6AU, UK.
J Clin Pathol. 2003 Dec;56(12):927-32. doi: 10.1136/jcp.56.12.927.
The burden of parasitic disease imported into the temperate zone is increasing, and in the tropics remains very high. Thus, high quality diagnostic parasitology services are needed, but to implement clinical governance a measure of quality of service is required.
To examine performance in the United Kingdom National External Quality Assessment Scheme for Parasitology for evidence of improved standards in parasite diagnosis in clinical specimens.
Analysis of performance was made for the period 1986 to 2001, to look for trends in performance scores.
An overall rise in performance in faecal and blood parasitology schemes was found from 1986 to 2001. This was seen particularly in the identification of ova, cysts, and larvae in the faecal scheme, the detection of Plasmodium ovale and Plasmodium vivax in the blood scheme, and also in the correct identification of non-malarial blood parasites. Despite this improvement, there are still problems. In the faecal scheme, participants still experience difficulty in recognising small protozoan cysts, differentiating vegetable matter from cysts, and detecting ova and cysts when more than one species is present. In the blood scheme, participants have problems in identifying mixed malarial infections, distinguishing between P ovale and P vivax, and estimating the percentage parasitaemia. The reasons underlying these problems have been identified via the educational part of the scheme, and have been dealt with by distributing teaching sheets and undertaking practical sessions.
UK NEQAS for Parasitology has helped to raise the standard of diagnostic parasitology in the UK.
输入到温带地区的寄生虫病负担正在增加,在热带地区仍然非常高。因此,需要高质量的诊断寄生虫学服务,但要实施临床治理,需要对服务质量进行衡量。
在英国国家寄生虫学外部质量评估计划中检查表现,以寻找临床标本中寄生虫诊断标准提高的证据。
对1986年至2001年期间的表现进行分析,以寻找表现分数的趋势。
1986年至2001年期间,粪便和血液寄生虫学计划的表现总体上升。这在粪便计划中虫卵、囊肿和幼虫的识别、血液计划中卵形疟原虫和间日疟原虫的检测以及非疟原虫血液寄生虫的正确识别中尤为明显。尽管有这种改善,但仍然存在问题。在粪便计划中,参与者在识别小的原生动物囊肿、区分蔬菜物质和囊肿以及当存在不止一种物种时检测虫卵和囊肿方面仍然存在困难。在血液计划中,参与者在识别混合疟疾感染、区分卵形疟原虫和间日疟原虫以及估计疟原虫血症百分比方面存在问题。通过该计划的教育部分确定了这些问题的潜在原因,并通过分发教学资料和开展实践课程来处理。
英国国家寄生虫学外部质量评估计划有助于提高英国诊断寄生虫学的标准。