Performance Outcomes from Africa-Based Malaria Diagnostic Competency Assessment Courses

Area of Science:

• Medical Diagnostics
• Parasitology
• Public Health Interventions

Background:

• Malaria diagnosis relies heavily on microscopy, requiring skilled laboratory personnel.
• External quality assurance is crucial for maintaining diagnostic accuracy in resource-limited settings.
• The Malaria Diagnostic Competency Assessment (MDCA) course was developed to address these needs.

Purpose of the Study:

• To evaluate the effectiveness of the 5-day MDCA course in improving malaria microscopy skills.
• To quantify improvements in parasite detection, species identification, and quantification.
• To assess the impact on diagnostic sensitivity and specificity.

Main Methods:

• A 5-day Malaria Diagnostic Competency Assessment (MDCA) course was delivered to 817 microscopists across nine African countries.
• Participant skills were assessed in parasite detection, species identification, and quantification.
• Performance was measured using pre- and post-course assessments.

Main Results:

• Mean scores significantly improved across all assessment areas (P < 0.001).
• Parasite detection, species identification, and quantification scores increased by 19.1%, 34.9%, and 38.2%, respectively.
• Sensitivity and specificity improved by 20.8% and 13.8%, respectively, with accurate *Plasmodium falciparum* identification rising to 67.1%.

Conclusions:

• The MDCA course rapidly and effectively enhances malaria microscopy performance.
• The course's rigor makes it suitable for assessing laboratory staff competency against national standards.
• The MDCA course can be adapted for national certification programs.