Developing standards for malaria microscopy: external competency assessment for malaria microscopists in the...

Area of Science:

• Medical Diagnostics
• Parasitology
• Public Health

Background:

• Light microscopy, a long-standing malaria diagnostic method, faces declining field standards despite its importance for parasite quantitation and drug monitoring.
• New guidelines emphasize parasite-based diagnosis, increasing the need for accurate and reliable microscopy.
• A quality assurance network was developed to address the gap between the need for and quality of malaria microscopy.

Purpose of the Study:

• To describe the development, function, and impact of a multi-country external quality assurance network for malaria microscopy in Asia.
• To assess the effectiveness of the quality assurance program in improving microscopist competency.

Main Methods:

• Utilized surveys with key informants and past participants for program feedback.
• Analyzed competency scores from 14 participating countries using paired sample t-tests.
• Conducted in-depth interviews with program facilitators and national microscopists.

Main Results:

• Formalized external assessments and retraining using a reference slide bank increased senior microscopist competence.
• The Asia-Pacific network expanded to over 14 countries, with methods adaptable to other regions.
• The program demonstrated potentially sustainable costs for improving diagnostic quality.

Conclusions:

• The quality assurance network has strengthened national malaria microscopy standards in some instances.
• The initiative supports the revival of national microscopy programs and the development of globally recognized competency standards.
• Improved microscopy is crucial for patient management and field research in malaria control.