Clinical audit on laboratory diagnosis of malaria parasites at Jimma University Medical Center laboratory, Southwest Ethiopia
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Background
Microscopic diagnosis using stained blood films is usually regarded as the gold standard and most acceptable method of diagnosis. There is no clinical audit performed at the Clinical Laboratory of Jimma University Medical Center, which aims to audit malaria diagnosis; therefore, this audit assesses the pre-analytic, analytic, and post-analytic processes that can affect the accuracy and quality of malaria diagnosis in this laboratory against the established acceptable standards of malaria diagnosis.
Method
We conducted a clinical audit at the Jimma University Medical Center Laboratory from January 2-20, 2025, using direct observation of the procedure that laboratory staff follow in blood collection, fixation, blood smear preparation, microscopic examination, reporting, and documentation of malaria diagnosis results, and also by re-examining the diagnosed slides to assess the skill of laboratory staff by maintaining confidentiality of the data.
Results
A total of 26 quality standards were used. It is known that 56.3 percent of the samples are collected from capillaries and 43.7 from veins. Approximately 78 percent of the samples were collected from properly rubbed fingers and 22% from fingers that were not rubbed adequately. All the blood samples collected with an anticoagulant were mixed properly before smearing (n=35), 78.8 % of the slides were preliminarily visualized using a high-power (100x) objective of the microscope, and only 17.5 % of the slides were visualized using a 10x objective.
Conclusion
Proper Disinfection, mixing the anti-coagulated blood well, and fixing thin blood films for the recommended length of time were areas of good practice. On the other hand, failure to report parasitic load and proper and sequential use of types of objectives to examine blood films and prepare smears of good quality were some of the highly violated standards that need consideration.
