High sensitivity and specificity of clinical microscopy in rural health facilities in western Kenya under an external quality assurance program.


Journal Article

Microscopic diagnosis of malaria is a well-established and inexpensive technique that has the potential to provide accurate diagnosis of malaria infection. However, it requires both training and experience. Although it is considered the gold standard in research settings, the sensitivity and specificity of routine microscopy for clinical care in the primary care setting has been reported to be unacceptably low. We established a monthly external quality assurance program to monitor the performance of clinical microscopy in 17 rural health centers in western Kenya. The average sensitivity over the 12-month period was 96% and the average specificity was 88%. We identified specific contextual factors that contributed to inadequate performance. Maintaining high-quality malaria diagnosis in high-volume, resource-constrained health facilities is possible.

Full Text

Duke Authors

Cited Authors

  • Wafula, R; Sang, E; Cheruiyot, O; Aboto, A; Menya, D; O'Meara, WP

Published Date

  • September 2014

Published In

Volume / Issue

  • 91 / 3

Start / End Page

  • 481 - 485

PubMed ID

  • 24935953

Pubmed Central ID

  • 24935953

Electronic International Standard Serial Number (EISSN)

  • 1476-1645

Digital Object Identifier (DOI)

  • 10.4269/ajtmh.14-0133


  • eng

Conference Location

  • United States