在埃塞俄比亚西北部,通过血涂片显微镜检查来检测和定量疟原虫的做法是否符合标准?
Does the practice of blood film microscopy for detection and quantification of malaria parasites in northwest Ethiopia fit the standard?
作者信息
Biadglegne Fantahun, Belyhun Yeshambel, Ali Jemal, Walle Fisha, Gudeta Nigussu, Kassu Afework, Mulu Andargachew
机构信息
Faculty of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Institute of Medical Microbiology and Epidemiology of Infectious Diseases, University of Leipzig, Leipzig, Germany.
出版信息
BMC Health Serv Res. 2014 Nov 1;14:529. doi: 10.1186/s12913-014-0529-x.
BACKGROUND
The diagnosis of malaria in clinical laboratories mainly depends on blood smear microscopy and this technique remains the most widely used in Ethiopia. Despite the importance of blood smear microscopy for patient's diagnosis and treatment, little effort has been made to precisely determine and identify sources of error in malaria smear microscopic diagnosis and quantification of parasitaemia. The main objective of the present study was to assess the laboratory practices of health care laboratories carrying out blood films microscopy.
METHODS
A cross sectional study was conducted in northwestern Ethiopia involving 29 health care institutes. A structured and pretested questionnaire were used to collect relevant information on the physical conditions, laboratory logistics and laboratory practices carrying out blood smear microscopy.
RESULTS
There was inadequacy of laboratory reagents, guidelines and materials. Most of the health institutes have been practicing re-utilization of microscope slides for malaria microscopy. The technical procedure (preparing of reagents, making of blood films and staining of the slides) were found to be below the standard in 50% of the health institutes. Refresher training and quality assessment has been done only in two and six of the health institutes in the past five years, respectively.
CONCLUSION
In most of the health care laboratories studied, availability of laboratory logistics and technical practices for malaria microscopy were found to be below the standard set by World Health Organization. Improving logistics access for malaria microscopy at all level of health care is important to increase accuracy of diagnosis and quantification of malaria parasites. Moreover, continued training and regular supervision of the staff and implementation of quality control program in the area is also crucial.
背景
临床实验室中疟疾的诊断主要依赖于血涂片显微镜检查,该技术在埃塞俄比亚仍然是使用最广泛的。尽管血涂片显微镜检查对患者的诊断和治疗很重要,但在精确确定和识别疟疾涂片显微镜诊断及寄生虫血症定量中的误差来源方面所做的努力很少。本研究的主要目的是评估进行血涂片显微镜检查的医疗保健实验室的实验室操作。
方法
在埃塞俄比亚西北部进行了一项横断面研究,涉及29个医疗保健机构。使用一份结构化且经过预测试的问卷来收集有关血涂片显微镜检查的物理条件、实验室后勤和实验室操作的相关信息。
结果
实验室试剂、指南和材料不足。大多数医疗机构一直在重复使用显微镜载玻片进行疟疾显微镜检查。在50%的医疗机构中,发现技术程序(试剂制备、血涂片制作和玻片染色)低于标准。在过去五年中,分别只有两个和六个医疗机构进行了进修培训和质量评估。
结论
在所研究的大多数医疗保健实验室中,发现疟疾显微镜检查的实验室后勤和技术操作低于世界卫生组织设定的标准。改善各级医疗保健机构疟疾显微镜检查的后勤保障对于提高疟疾寄生虫诊断和定量的准确性很重要。此外,持续培训和定期监督工作人员以及在该领域实施质量控制计划也至关重要。