Population and Family Health, Mailman School of Public Health, Columbia University, New York, New York.
President's Malaria Initiative (PMI) MalariaCare Project, PATH, Washington, District of Columbia.
Am J Trop Med Hyg. 2019 Apr;100(4):876-881. doi: 10.4269/ajtmh.18-0364.
Rapid diagnostic tests (RDTs) are one of the primary tools used for parasitological confirmation of suspected cases of malaria. To ensure accurate results, health-care workers (HCWs) must conduct the RDT test correctly. Trained supervisors visited 3,603 facilities to assess RDT testing performance and conduct outreach training and supportive supervision activities in eight African countries between 2015 and 2017, using a 12-point checklist to determine if key steps were being performed. The proportion of HCWs performing each step correctly improved between 1.1 and 21.0 percentage points between the first and third visits. Health-care worker scores were averaged to calculate facility scores, which were found to be high: the average score across all facilities was 85% during the first visit and increased to 91% during the third visit. A regression analysis of these facility scores estimated that, holding key facility factors equal, facility performance improved by 5.3 percentage points from the first to the second visit ( < 0.001), but performance improved only by 0.6 percentage points ( = 0.10) between the second and third visits. Factors strongly associated with higher scores included the presence of a laboratory worker at the facility and the presence of at least one staff member with previous formal training in malaria RDTs. Findings confirm that a comprehensive quality assurance system of training and supportive supervision consistently, and often significantly, improves RDT performance.
快速诊断检测（RDT）是用于寄生虫学确认疑似疟疾病例的主要工具之一。为确保准确的结果，医护人员（HCW）必须正确进行 RDT 测试。在 2015 年至 2017 年期间，经过培训的监督人员访问了 3603 个设施，评估 RDT 检测性能，并在八个非洲国家开展外展培训和支持性监督活动，使用 12 点清单确定是否正在执行关键步骤。HCW 正确执行每个步骤的比例在第一次和第三次访问之间提高了 1.1 到 21.0 个百分点。医护人员的分数被平均计算以计算设施的分数，发现分数很高：所有设施的平均分数在第一次访问时为 85%，在第三次访问时增加到 91%。对这些设施分数的回归分析估计，在保持关键设施因素相等的情况下，设施的性能从第一次访问提高了 5.3 个百分点（<0.001），但在第二次和第三次访问之间仅提高了 0.6 个百分点（=0.10）。与更高分数强烈相关的因素包括该设施有实验室工作人员和至少有一名具有疟疾 RDT 先前正式培训的工作人员。研究结果证实，一个全面的质量保证系统的培训和支持性监督可以持续、且通常显著提高 RDT 的性能。
