PERFORMANCE EVALUATION OF MEDICAL LABORATORY PROFESSIONALS’ ON MALARIA MICROSCOPY, AFAR REGIONAL STATE, NORTH-EAST ETHIOPIA, 2017

Abstract

Abstract Introduction: Light microscopy is a gold standard method to malaria diagnosis. The effectiveness of malaria microscopy depends on maintaining a high level of staff performance. The aim of this study is to evaluate performance of laboratory professionals working in Health Facility Laboratories of Afar Region on malaria microscopy through proficiency slides and factors influencing their performance. Method: We implemented institution based cross sectional study. We measured the performance of each laboratory professionals with 23 panel malaria slides. Microscopists achieving ≥90% sensitivity and ≥80% specificity and 95% Plasmodium falciparum detection (if present) were good performer otherwise poor performer. We collected data from November 13 to December 26, 2017 and entered to Epi Info version 7 and analyzed by SPSS version 21. We equated associated factor with performance through binary logistic regression. Odds ratio, p-value and 95% confidence interval was used to test association. Result: Of the total 119 laboratory professionals working in Afar Region 99 (83.2%) professionals participated on this research. Of the total participants only 48(48.5%) not fulfilled the criteria to diagnose malaria at periphery level. Of total 2277 distributed slides, 1683(73.9%) correctly read and of 99 low load Plasmodium Vivax species 22(22.2%) slides correctly read. The overall Sensitivity and specificity was 86.7% (Kappa=0.73). Laboratory professionals trained malaria microscopy had better performance than not trained [AOR]=3.894, CI=1.329 11.410. Laboratory professionals with good theoretical knowledge had good performance than had poor theoretical knowledge. (AOR=4.067, CI=1.327-12.469, P=0.014). Laboratory professionals with less than 2 year experience had poor performance than those have more than 5 year experience (AOR=0.124, CI=0.030-0.51 1.943). Conclusion and recommendation: Performance of laboratory professionals working in Afar region on malaria diagnosis under light microscopy was poor and not sufficiently skilled to detect the low density parasitaemia that help to malaria elimination program. Providing training and regular competence evaluation may improve their performance.