Wafula Rebeccah, Sang Edna, Cheruiyot Olympia, Aboto Angeline, Menya Diana, O'Meara Wendy Prudhomme
Academic Model Providing Access to Healthcare, Eldoret, Kenya; Ministry of Health, Uasin Gishu County, Eldoret, Kenya; School of Public Health, Moi University College of Health Sciences, Eldoret, Kenya; Duke University School of Medicine, Durham, North Carolina; Duke Global Health Institute, Durham, North Carolina.
Academic Model Providing Access to Healthcare, Eldoret, Kenya; Ministry of Health, Uasin Gishu County, Eldoret, Kenya; School of Public Health, Moi University College of Health Sciences, Eldoret, Kenya; Duke University School of Medicine, Durham, North Carolina; Duke Global Health Institute, Durham, North Carolina
Am J Trop Med Hyg. 2014 Sep;91(3):481-5. doi: 10.4269/ajtmh.14-0133. Epub 2014 Jun 16.
Microscopic diagnosis of malaria is a well-established and inexpensive technique that has the potential to provide accurate diagnosis of malaria infection. However, it requires both training and experience. Although it is considered the gold standard in research settings, the sensitivity and specificity of routine microscopy for clinical care in the primary care setting has been reported to be unacceptably low. We established a monthly external quality assurance program to monitor the performance of clinical microscopy in 17 rural health centers in western Kenya. The average sensitivity over the 12-month period was 96% and the average specificity was 88%. We identified specific contextual factors that contributed to inadequate performance. Maintaining high-quality malaria diagnosis in high-volume, resource-constrained health facilities is possible.
疟疾的显微镜诊断是一项成熟且成本低廉的技术，有潜力对疟疾感染进行准确诊断。然而，这需要培训和经验。尽管它在研究环境中被视为金标准，但据报道，基层医疗环境中常规显微镜检查用于临床护理的敏感性和特异性低得令人无法接受。我们建立了一个月度外部质量保证项目，以监测肯尼亚西部17个农村卫生中心临床显微镜检查的表现。在这12个月期间，平均敏感性为96%，平均特异性为88%。我们确定了导致表现不佳的具体背景因素。在高工作量、资源有限的卫生设施中维持高质量的疟疾诊断是可行的。
