Quality of malaria microscopy in 12 district hospital laboratories in Tanzania
Quality of malaria microscopy in 12 district hospital laboratories in Tanzania
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DOI：
10.1179/2047773212y.0000000052
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发表时间：
2012-10-01
影响因子：
3.4
通讯作者：
Reyburn, Hugh
中科院分区：
文献类型：
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作者：
Mbakilwa, Hilda;Manga, Chacha;Reyburn, Hugh
背景资料：世卫组织的建议，疟疾的寄生虫学诊断在可能的情况下是挑战的证据，质量差的显微镜在非洲医院，但原因尚不清楚。方法：所有12个繁忙的地区医院实验室从坦桑尼亚的三个地区进行了评估的工作环境质量和幻灯片阅读器阅读10参考幻灯片考试条件下。结果：在研究中的44个载玻片读取器中，39个（88.6%）正确读取>90%的参考载玻片。在206张常规读取的载玻片中，33张（16%）被判定为不可读，104张（51%）难以读取，69张（34%）易于读取。与专家阅读结果相比，易阅片常规结果的敏感性为85.7%（95%置信区间：77.4-94.0），降至44.4%（95%置信区间：34.5-54.4）对于“难以读取”的载玻片。结果不准确的最常见原因是幻灯片本身的质量，在现有资源范围内可能可以纠正。少数幻灯片阅读员即使在理想条件下也无法阅读幻灯片，这表明需要"幻灯片阅读许可证“计划。
Background: The WHO recommendation for parasitological diagnosis of malaria wherever possible is challenged by evidence of poor-quality microscopy in African hospitals but the reasons are not clear.Methods: All 12 of the busier district hospital laboratories from three regions of Tanzania were assessed for quality of the working environment and slide readers read 10 reference slides under exam conditions. Slides that had been routinely read were removed for expert reading.Results: Of 44 slide readers in the study, 39 (88.6%) correctly read >90% of the reference slides. Of 206 slides that had been routinely read, 33 (16%) were judged to be unreadable, 104 (51%) were readable with difficulty, and 69 (34%) were easily readable. Compared to expert reading of the same slide, the sensitivity of routine slide results of easily readable slides was 85.7% (95% confidence interval: 77.4-94.0), falling to 44.4% (95% confidence interval: 34.5-54.4) for slides that were 'readable with difficulty'.Conclusions: The commonest cause of inaccurate results was the quality of the slide itself, correction of which is likely to be achievable within existing resources. A minority of slide readers were unable to read slides even under ideal conditions, suggesting the need for a 'slide reading licence' scheme.