Evidence map›Paper›PMID 28903758›Full record

ArticleMalaria journal2017

Factors associated with malaria microscopy diagnostic performance following a pilot quality-assurance programme in health facilities in malaria low-transmission areas of Kenya, 2014.

Fredrick Odhiambo, Ann M Buff, Collins Moranga, Caroline M Moseti, Jesca Okwara Wesongah, Sara A Lowther, Wences Arvelo, Tura Galgalo, Thomas O Achia, Zeinab G Roka and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Malaria journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Multiple blood pathogen infections in apparently healthy sheltered dogs in southern Thailand.International journal of veterinary science and medicine · 2022
    Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Fredrick OdhiamboField Epidemiology and Laboratory Training Programme, P.O. Box 225-00202, Nairobi, Kenya. odhiambof@yahoo.com.
Ann M BuffDivision of Parasitic Diseases and Malaria, Center for Global Health, U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30333, USA.
Collins MorangaUnited States Army Medical Research Unit-Kenya, Malaria Diagnostics Center, P.O. Box 54, Kisumu, 40100, Kenya.
Caroline M MosetiUnited States Army Medical Research Unit-Kenya, Malaria Diagnostics Center, P.O. Box 54, Kisumu, 40100, Kenya.
Jesca Okwara WesongahJomo Kenyatta University of Agriculture and Technology, P.O. Box 62000-00200, Nairobi, Kenya.
Sara A LowtherDivision of Parasitic Diseases and Malaria, Center for Global Health, U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30333, USA.
Wences ArveloDivision of Parasitic Diseases and Malaria, Center for Global Health, U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30333, USA.
Tura GalgaloField Epidemiology and Laboratory Training Programme, P.O. Box 225-00202, Nairobi, Kenya.
Thomas O AchiaDivision of Parasitic Diseases and Malaria, Center for Global Health, U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30333, USA.
Zeinab G RokaField Epidemiology and Laboratory Training Programme, P.O. Box 225-00202, Nairobi, Kenya.
Waqo BoruField Epidemiology and Laboratory Training Programme, P.O. Box 225-00202, Nairobi, Kenya.
Lily ChepkuruiField Epidemiology and Laboratory Training Programme, P.O. Box 225-00202, Nairobi, Kenya.
Bernhards OgutuUnited States Army Medical Research Unit-Kenya, Malaria Diagnostics Center, P.O. Box 54, Kisumu, 40100, Kenya.
Elizabeth WanjaUnited States Army Medical Research Unit-Kenya, Malaria Diagnostics Center, P.O. Box 54, Kisumu, 40100, Kenya.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMalaria accounts for ~21% of outpatient visits annually in Kenya; prompt and accurate malaria diagnosis is critical to ensure proper treatment. In 2013, formal malaria microscopy refresher training for microscopists and a pilot quality-assurance (QA) programme for malaria diagnostics were independently implemented to improve malaria microscopy diagnosis in malaria low-transmission areas of Kenya. A study was conducted to identify factors associated with malaria microscopy performance in the same areas.

methodsFrom March to April 2014, a cross-sectional survey was conducted in 42 public health facilities; 21 were QA-pilot facilities. In each facility, 18 malaria thick blood slides archived during January-February 2014 were selected by simple random sampling. Each malaria slide was re-examined by two expert microscopists masked to health-facility results. Expert results were used as the reference for microscopy performance measures. Logistic regression with specific random effects modelling was performed to identify factors associated with accurate malaria microscopy diagnosis.

resultsOf 756 malaria slides collected, 204 (27%) were read as positive by health-facility microscopists and 103 (14%) as positive by experts. Overall, 93% of slide results from QA-pilot facilities were concordant with expert reference compared to 77% in non-QA pilot facilities (p < 0.001). Recently trained microscopists in QA-pilot facilities performed better on microscopy performance measures with 97% sensitivity and 100% specificity compared to those in non-QA pilot facilities (69% sensitivity; 93% specificity; p < 0.01). The overall inter-reader agreement between QA-pilot facilities and experts was κ = 0.80 (95% CI 0.74-0.88) compared to κ = 0.35 (95% CI 0.24-0.46) between non-QA pilot facilities and experts (p < 0.001). In adjusted multivariable logistic regression analysis, recent microscopy refresher training (prevalence ratio [PR] = 13.8; 95% CI 4.6-41.4), ≥5 years of work experience (PR = 3.8; 95% CI 1.5-9.9), and pilot QA programme participation (PR = 4.3; 95% CI 1.0-11.0) were significantly associated with accurate malaria diagnosis.

conclusionsMicroscopists who had recently completed refresher training and worked in a QA-pilot facility performed the best overall. The QA programme and formal microscopy refresher training should be systematically implemented together to improve parasitological diagnosis of malaria by microscopy in Kenya.

Indexed as

Health FacilitiesCross-Sectional StudiesHumansKenyaMalariaMicroscopyPilot ProjectsPrevalenceQuality Assurance, Health CareSensitivity and SpecificityInterpretationKenyaLaboratoryMalariaMicroscopyQuality assuranceReliabilityValidity

Identifiers

PMID28903758
PMCPMC5598012

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.