Assessing the performance of Laboratory professionals following a day of malaria microscopy training in Kano, Nigeria

Abstract

Malaria is a global health burden with a projection of 247 million cases in 2021 in 84 countries known to be malaria-endemic. The majority of the cases are expected to occur in WHO African Region countries inclusive of Nigeria where the disease is a public health concern particularly in the northern regions. This study aimed to evaluate the effectiveness of a one-day malaria microscopy training program for laboratory professionals in Kano, Nigeria, and to assess the impact of the training on their proficiency in detecting malaria parasites. A total of 56 medical laboratory professionals from both public and private healthcare facilities participated in the training, which was based on the WHO basic microscopy learners guide. The training included theoretical and practical components, focusing on blood film preparation, staining techniques, and identification of Plasmodium species. Participants' knowledge was assessed before and after the training using a pre-test and post-test survey, and their proficiency in malaria diagnosis was evaluated through the examination of a panel of stained blood slides. The sensitivity and specificity of the participants in detecting malaria parasites were determined as 66% and 34% respectively, indicating moderate sensitivity but very low specificity. A significant improvement in participants' knowledge of malaria detection was observed post-training, with private facilities showing a median knowledge score increase from 47.5% to 65.0%, and public facilities from 55.0% to 70.0%. However, the overall agreement between participant readers and an expert reader, measured by the kappa coefficient, was zero, suggesting no agreement beyond chance. The study highlighted the need for enhanced training and standardization in malaria microscopy to improve diagnostic accuracy. Despite the moderate increase in knowledge and sensitivity post-training, the low specificity and agreement underscore the importance of ongoing education and quality assurance measures in malaria diagnosis, especially in high-prevalence settings like Kano.