Ayalew Freshwork, Tilahun Birkneh, Taye Bineyam
College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
BMC Res Notes. 2014 Nov 25;7:839. doi: 10.1186/1756-0500-7-839.
BACKGROUND: Microscopic diagnosis of Giemsa stained thick and thin blood films by skilled microscopists has remained the standard laboratory method for the diagnosis of malaria. However, detection and identification of malaria parasites require well trained laboratory personnel.The objective of the study was to evaluate the performance of laboratory technologists and technicians in detecting and identifying malaria parasites in Hawassa town, Southern Ethiopia. METHODS: A cross-sectional study design was employed among a total of 80 laboratory professionals working in public and private health facilities. A standardized pre-validated slide panel and questionnaires were distributed to laboratory professionals working at eleven health facilities in Hawassa town, Southern Ethiopia. The panels included ten slides for diagnosis, [slide1:P.falciparum, 104/μl; slide 2:P.falciparum, 53404/μl; slide 3 and 4: mixed infection (both P. falciparum and P. vivax); slide 5:P.vivax, 23503/μl; slide 6:P.vivax, 400/μl; and slides 7, 8, 9 and 10: negative slides]. Participants were asked to return the responses which were compared with expert microscopist. Agreement in detecting and identifying malaria parasites between participants and expert microscopists was estimated using the Kappa score. RESULTS: The mean age of the participants was 27 (SD=4.1) years. More than half of the participants (56.9%) were female. Fourteen (19.4%) of the participants correctly reported all the ten distributed slides, whereas 58(80.6%) missed at least one slide. Overall, the sensitivity and specificity of participants in detection of malaria parasites were 82% and 96.5% respectively. The overall agreement between participants and reference readers on detection of malaria parasite was 88% (Kappa=0.76) while on identification of malaria species was 74.3% (kappa=0.63). Lower agreement on detection and identification of slides with low parasitic density and mixed infection were observed. Agreement was relatively lower for government health centers (69%; kappa=0.56). None of the participants reported parasitic load per micro liter method. CONCLUSION: Agreement of the participants with expert microscopist in the detection of malaria parasites was better than agreement in the identification of different species of malaria. Poor agreement was reported in detection of parasites at a low density and mixed infections.
背景:由经验丰富的显微镜技师对吉姆萨染色的厚薄血膜进行显微镜诊断,一直是疟疾诊断的标准实验室方法。然而,疟原虫的检测和鉴定需要训练有素的实验室人员。本研究的目的是评估埃塞俄比亚南部哈瓦萨镇实验室技术人员和技术员在检测和鉴定疟原虫方面的表现。 方法:采用横断面研究设计,对在公共和私立卫生机构工作的80名实验室专业人员进行研究。向埃塞俄比亚南部哈瓦萨镇11家卫生机构的实验室专业人员分发了标准化的预验证载玻片组和问卷。载玻片组包括10张用于诊断的玻片,[玻片1:恶性疟原虫,104/μl;玻片2:恶性疟原虫,53404/μl;玻片3和4:混合感染(恶性疟原虫和间日疟原虫);玻片5:间日疟原虫,23503/μl;玻片6:间日疟原虫,400/μl;玻片7、8、9和10:阴性玻片]。要求参与者返回结果,并与专业显微镜技师的结果进行比较。使用Kappa评分评估参与者与专业显微镜技师在检测和鉴定疟原虫方面的一致性。 结果:参与者的平均年龄为27岁(标准差=4.1)。超过一半的参与者(56.9%)为女性。14名(19.4%)参与者正确报告了所有10张分发的玻片,而58名(80.6%)参与者至少漏报了一张玻片。总体而言,参与者检测疟原虫的敏感性和特异性分别为82%和96.5%。参与者与参考读者在疟原虫检测方面的总体一致性为88%(Kappa=0.76),在疟原虫种类鉴定方面的一致性为74.3%(kappa=0.63)。在低寄生虫密度和混合感染玻片的检测和鉴定方面,一致性较低。政府卫生中心的一致性相对较低(69%;kappa=0.56)。没有参与者报告每微升寄生虫载量的方法。 结论:参与者与专业显微镜技师在疟原虫检测方面的一致性优于在不同疟原虫种类鉴定方面的一致性。在低密度寄生虫检测和混合感染方面,一致性较差。
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