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Impact of introducing integrated quality assessment for tuberculosis and malaria microscopy in Kano, Nigeria

Sarkinfada, F., Aliyu, Y., Chavasse, C. and Bates, Imelda ORCID: (2009) 'Impact of introducing integrated quality assessment for tuberculosis and malaria microscopy in Kano, Nigeria'. Journal of Infection in Developing Countries, Vol 3, Issue 1, pp. 20-27.

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Background: The World Health Organization (WHO) has recommended the integration of malaria microscopy quality assessment (QA) with that of other microscopically diagnosed diseases, but there is no evidence that it has been attempted. We assessed the feasibility of linking malaria microscopy into the existing tuberculosis (TB) microscopy QA system in Kano, Nigeria. Methodology: Five TB microscopy centres were selected for implementing the integrated TB and malaria microscopy QA scheme in the state. A model system was designed for selecting and blinded rechecking of TB and malaria slides from these laboratories. Supervision and evaluation was conducted at 3-month intervals for 24 months. Results: TB microscopy QA was strengthened in four laboratories. Full integration of the QA for TB and malaria microscopy was achieved in two laboratories, and partial integration in two other laboratories. The programme resulted in an increase in the specificity of both TB and malaria microscopy results. At the final assessment, 100% specificity was achieved for TB microscopy results in four laboratories. There was an increased concordance rate and decreased false positivity and false negativity rates of TB microscopy results in all five laboratories. Conclusions: It is feasible to integrate the QA system and training for TB and malaria microscopy for assessing and improving quality of both services. However, the integrated system needs testing in different settings in order to be able to develop sound recommendations to guide the complex scaling-up process.

Item Type: Article
Additional Information: Export Date: 24 November 2009 Source: Scopus Language of Original Document: English Correspondence Address: Sarkinfada, F.; Department of Medical Microbiology and Parasitology, Faculty of Medicine, Bayero University, P.M.B. 3011, Kano, Nigeria; email:
Uncontrolled Keywords: Kano Malaria Microscopy Quality Tuberculosis article clinical protocol diagnostic accuracy diagnostic error diagnostic value false negative result false positive result feasibility study health program laboratory Nigeria quality control sensitivity and specificity
Subjects: WB Practice of Medicine > Diagnosis > General Diagnosis > WB 143 Signs and symptoms
WB Practice of Medicine > Diagnosis > General Diagnosis > WB 141 General works
WB Practice of Medicine > Diagnosis > General Diagnosis > WB 200 Physical diagnosis (General)
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
QY Clinical Pathology > QY 4 General works
QY Clinical Pathology > Diagnostic Tests > QY 250 Immunodiagnostic tests
Faculty: Department: Groups (2002 - 2012) > Disease Control Strategy Group
Depositing User: Tina Bowers
Date Deposited: 17 Mar 2010 18:03
Last Modified: 22 Oct 2019 08:20


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