title: Quality assessment of malaria laboratory diagnosis in South Africa.
abstract: To assess the quality of malaria diagnosis in 115 South African laboratories participating in the National Health Laboratory Service Parasitology External Quality Assessment Programme we reviewed the results from 7 surveys from January 2000 to August 2002. The mean percentage incorrect result rate was 13.8% (95% CI 11.3-16.9%), which is alarmingly high, with about 1 in 7 blood films being incorrectly interpreted. Most participants with incorrect blood film interpretations had acceptable Giemsa staining quality, indicating that there is less of a problem with staining technique than with blood film interpretation. Laboratories in provinces in which malaria is endemic did not necessarily perform better than those in non-endemic areas. The results clearly suggest that malaria laboratory diagnosis throughout South Africa needs strengthening by improving laboratory standardization and auditing, training, quality assurance and referral resources.
authors.affiliation: Parasitology Reference Unit, National Institute for Communicable Diseases, National Health Laboratory Service, Box 1038, Johannesburg 2000, South Africa. leigh.dini@nhls.ac.za
authors.forename: Leigh
authors.initials: L
authors.lastname: Dini
authors.forename: John
authors.initials: J
authors.lastname: Frean
mesh_terms: D019411:Clinical Laboratory Techniques / Q000592:standards*; D003951:Diagnostic Errors; D006801:Humans; D008288:Malaria / Q000175:diagnosis*; D010274:Parasitology / Q000592:standards*; D011785:Quality Assurance, Health Care; D012680:Sensitivity and Specificity; D013019:South Africa