Malaria Diagnostic Practices in U.S. Laboratories in 2017.

Area of Science:

• Clinical diagnostics
• Laboratory medicine
• Infectious disease pathology

Background:

• Malaria diagnosis in the U.S. relies on microscopic blood smear examination.
• Limited malaria endemicity in the U.S. may lead to diagnostic delays and increased patient morbidity and mortality.
• Assessing current malaria diagnostic practices is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the malaria diagnostic practices of U.S. laboratories.
• To assess laboratory compliance with Clinical and Laboratory Standards Institute (CLSI) guidelines for malaria diagnostics.
• To identify areas for improvement in malaria diagnostic capabilities and reporting.

Main Methods:

• A survey was distributed to U.S. laboratories via the American Society for Microbiology listserv from June to July 2017.
• Questionnaires inquired about malaria diagnostic test availability, techniques, and reporting.
• Responses were analyzed against CLSI guidelines, with 175 laboratories included in the final analysis.

Main Results:

• 99% of labs received at least one malaria specimen annually, but 31% received only 1-10 specimens.
• 74% of labs diagnosed five or fewer malaria cases per year; 90% performed blood smears on-site.
• While 74% offered 24/7 testing, only 12% met CLSI criteria for analysis and reporting, a significant increase from 3% in 2010 (P < 0.05).

Conclusions:

• Most U.S. laboratories possess the capability for timely malaria diagnosis.
• Low case volume contributes to inexperience and noncompliance with CLSI guidelines.
• Despite improvements, enhancing laboratory adherence to CLSI recommendations is essential for accurate and efficient malaria diagnosis.