Factors influencing quality assurance of malaria microscopy at Kajaani health centre IV, Wakiso district. A cross-sectional study.
DOI:
https://doi.org/10.51168/sjhrafrica.v7i3.2303Keywords:
Malaria microscopy, Quality assurance, Diagnostic accuracy, pre-analytical factors, Health laboratory services, Wakiso DistrictAbstract
Background:
Malaria microscopy remains the gold standard for laboratory diagnosis of malaria; however, its accuracy depends on effective quality assurance practices across pre-analytical, analytical, and post-analytical phases. This study assessed the factors influencing quality assurance of malaria microscopy at Kajjansi Health Centre IV in Wakiso District, Uganda.
Methodology:
A descriptive cross-sectional study employing quantitative methods was conducted among 84 healthcare workers, including laboratory personnel, interns, and volunteers. Participants were selected using simple random sampling. Data were collected using semi-structured questionnaires and analyzed using SPSS version 17.0 and Microsoft Excel. Descriptive statistics such as frequencies and percentages were used to summarize findings.
Results:
The majority of respondents were male (64.3%) and below 25 years (47.6%). About 71.4% had heard about malaria microscopy quality assurance, while 65.5% had practiced it. Key quality assurance practices included slide labeling (100%), correct sample collection (98.8%), and proper completion of request forms (94%). However, 8.3% reported using expired reagents. In-service training (83.3%) and cross-checking of results (96.4%) were associated with improved diagnostic accuracy. Pre-analytical errors, such as poor labeling, contributed to mixing up patient results (56%), while analytical challenges included inaccurate parasite quantification (50%). Major constraints identified were a lack of adequate workspace (66.7%), limited resources (45.2%), and unreliable electricity supply (17.9%). Motivation factors included fair pay (41.7%) and career growth (26.2%).
Conclusion:
Quality assurance practices significantly improve the accuracy of malaria microscopy; however, gaps remain due to infrastructural limitations, inadequate resources, and inconsistent adherence to quality protocols.
Recommendations:
Health facilities should strengthen continuous professional training, ensure a consistent supply of laboratory resources, and improve infrastructure, such as workspace and electricity. Implementation of regular supervision and external quality assurance programs is essential to enhance diagnostic accuracy and patient outcomes.
References
Centers for Disease Control and Prevention (2023). Malaria diagnosis (U.S.). Atlanta, GA: CDC.
World Health Organization (2016). Malaria microscopy quality assurance manual (2nd ed.). Geneva: WHO.
World Health Organization (2023). Quality of care: A process for making strategic choices in health systems. Geneva: WHO.
Naing Cho et al. (2022). Accuracy of rapid diagnostic tests and microscopy for detection of asymptomatic malaria: A systematic review.
Sori Getahun et al. (2018). Quality of malaria microscopy diagnosis in health facility laboratories in Ethiopia.
Moura Sandra et al. (2014). Impact of training on the quality of malaria microscopy diagnosis in Angola.
https://doi.org/10.1186/1475-2875-13-437
Odhiambo Fredrick et al. (2017). Accuracy of malaria microscopy in low transmission settings in Kenya.
Ngasala Billy & Bushukatale Samuel (2019). Quality of malaria microscopy in private health facilities in Tanzania.
https://doi.org/10.1186/s12936-019-2998-1
Mutabazi Daniel et al. (2021). Accuracy of malaria microscopy in private health facilities in Uganda.
https://doi.org/10.21203/rs.3.rs-266341/v1
Alomba Francis et al. (2019). Effect of supportive supervision on malaria microscopy performance in Sub-Saharan Africa. https://doi.org/10.4269/ajtmh.18-0363
Gidey Kiflemariam et al. (2021). Sensitivity and specificity of routine malaria slide reading and re-checking.
Kigozi Richard N et al. (2021). Determinants of malaria testing and diagnostic practices in Uganda.
https://doi.org/10.1186/s12936-021-03992-9
Kish Leslie (1965). Survey sampling. New York: John Wiley & Sons.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Sharuwat Mbatidde, Frank Anthony Ssegujja, Hasifa Nansereko, Fransisco Ssemuwemba, Jane Frank Nalubega, Anthony Isaiah Ssekitoleko

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
















