Department of Medical Laboratory Science, College of Health Sciences, Woldia University, Woldia, Ethiopia.
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
PLoS One. 2021 Apr 8;16(4):e0249708. doi: 10.1371/journal.pone.0249708. eCollection 2021.
BACKGROUND: In Ethiopia, anti-malaria treatment is initiated after parasitological confirmation using blood film microscopy at health centers and hospitals, or serological rapid diagnostic tests at health posts. At health posts, the diagnosis is performed by health extension workers using rapid diagnostic tests after little training. However, there is paucity of data about the health extension workers' performance on rapid diagnostic tests. Hence, periodic monitoring of the performances of health extension workers on malaria rapid diagnostic tests and predicted factors plays a pivotal role for the control of malaria. METHODS: A cross sectional study was conducted in May 2020, among 75 health extension workers working at health posts in Bahir Dar Zuria district, Northwest Ethiopia. Their performance on malaria rapid diagnostic tests was assessed by distributing known positive and negative samples as confirmed by investigators using both rapid diagnostic test and blood film microscopy. Test results from health extension workers were then compared with that of investigators. Procedural errors committed while performing the tests were assessed using observational checklist. Data were analyzed using SPSS software version 20. RESULTS: The overall sensitivity and specificity of health extension workers in detecting Plasmodium species were 96.8% and 98.7%, respectively with 97.3% result agreement between the health extension workers and investigators (kappa value = 0.949). The most common procedural errors committed by health extension workers was 'not checking expiry date of the test kits' followed by 'not adhering to the appropriate time of reading results' that 70.7% and 64% of the participants committed these errors, respectively. Total number of procedural errors committed by those who have got in-service training was decreased by 47.3% as compared to those without in-service training. CONCLUSIONS: Health extension workers had high performance on malaria rapid diagnostic tests. However, in-service training and periodic supervision should be given in order to maximize performance on these tests.
背景：在埃塞俄比亚，抗疟治疗是在卫生中心和医院通过血片显微镜进行寄生虫学确认后开始的，或者在卫生所使用血清学快速诊断检测。在卫生所，经过少量培训，卫生推广工作者使用快速诊断检测进行诊断。然而，关于卫生推广工作者快速诊断检测性能的数据很少。因此，定期监测卫生推广工作者对疟疾快速诊断检测的表现和预测因素对于控制疟疾至关重要。
方法：2020 年 5 月，在埃塞俄比亚西北部巴希尔达尔祖里亚区的 75 名卫生推广工作者中进行了一项横断面研究。通过分发已知的阳性和阴性样本，由调查人员使用快速诊断检测和血片显微镜进行确认，评估卫生推广工作者对疟疾快速诊断检测的性能。然后将卫生推广工作者的检测结果与调查人员的检测结果进行比较。使用观察检查表评估在进行检测时犯的程序错误。使用 SPSS 软件版本 20 对数据进行分析。
结果：卫生推广工作者检测疟原虫种类的总灵敏度和特异性分别为 96.8%和 98.7%，卫生推广工作者和调查人员之间的结果一致性为 97.3%（kappa 值=0.949）。卫生推广工作者最常见的程序错误是“未检查检测试剂盒的有效期”，其次是“未遵守适当的读值时间”，分别有 70.7%和 64%的参与者犯了这些错误。与没有接受在职培训的人相比，接受在职培训的人犯的总程序错误减少了 47.3%。
结论：卫生推广工作者在疟疾快速诊断检测方面表现出色。然而，应该提供在职培训和定期监督，以最大限度地提高这些检测的性能。
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