A regional centralized microbiology service in Calgary for the rapid diagnosis of malaria.
BACKGROUND
A regional centralized laboratory service for the rapid diagnosis of malaria was implemented 3 years ago in May 1999 within the Division of Microbiology, Calgary Laboratory Services.


OBJECTIVE
To describe the design and performance of this unique microbiology laboratory service.


METHODS
Blood specimens must arrive at the central laboratory within 2 hours of collection. Thin blood smears are read and reported from suspected acute cases within 1 hour of receipt, 24 hours per day, 7 days a week, by trained and experienced microbiology technologists. All positive malaria smears are reviewed by a medical microbiologist and confirmed by polymerase chain reaction at a reference laboratory.


METHODS
Calgary Laboratory Services provides integrated laboratory services to the Calgary Health Region, an urban area of more than 1 million people.


METHODS
Performance of the service has been continuously monitored by measuring preanalytic and analytic test turnaround times, test accuracy, clinical relevance, and the results of proficiency testing.


RESULTS
More than 90% of blood specimens for malaria from community locations have consistently arrived within 2 hours of collection, and hospitals have reached this target within the past year. Although polymerase chain reaction was more sensitive at detecting the presence of malaria, the expert microscopists were as accurate at determining the type of Plasmodium infection. More than 95% of all positive smear results are consistently reported within 2 hours of receipt of a blood specimen.


CONCLUSIONS
Implementation of a regional centralized microbiology service has improved our ability to make a rapid and accurate diagnosis of malaria in this region.
Calgary Laboratory Services, Calgary, Alberta, Canada T3C 0J5. deirdre.church@cls.ab.ca
Deirdre L
DL
Church
Angelika
A
Lichtenfeld
Sameer
S
Elsayed
Susan
S
Kuhn
Daniel B
DB
Gregson
D000416:Alberta; D000818:Animals; D001800:Blood Specimen Collection / Q000379:methods / Q000592:standards; D002497:Centralized Hospital Services / Q000379:methods* / Q000458:organization & administration*; D003162:Competency-Based Education / Q000379:methods; D006752:Hospital Planning / Q000379:methods / Q000458:organization & administration; D006801:Humans; D007755:Laboratories, Hospital / Q000592:standards / Q000706:statistics & numerical data; D016778:Malaria, Falciparum / Q000175:diagnosis*; D016780:Malaria, Vivax / Q000175:diagnosis*; D008828:Microbiological Techniques / Q000592:standards / Q000706:statistics & numerical data; D010338:Pathology, Clinical / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D010963:Plasmodium falciparum / Q000302:isolation & purification; D010966:Plasmodium vivax / Q000302:isolation & purification; D016133:Polymerase Chain Reaction / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000379:methods; D013048:Specimen Handling; D019037:Urban Health Services / Q000458:organization & administration