The Department of Health-Philippines, in collaboration and with support from ACTMalaria, World Health Organization Mekong Malaria Programme, the Western Pacific Regional Office (WPRO) and the South East Asia Regional Office (SEARO) will convene a "Strengthening Quality Assurance System of Giemsa Malaria Microscopy Planning Workshop in the ACTMalaria member countries and in the countries of the Pacific" on May 2-4, Manila, Philippines.
Early diagnosis and appropriate treatment is one of the key strategies for malaria prevention and control. It requires, among others, a network of facilities with quality assured capability for diagnosis of malaria. However, despite having Giemsa Malaria Microscopy (GMM) as the globally recognized gold standard for the diagnosis of human malaria, varying accuracy and poorly understood quality assurance (QA) requirements continue as common problems in many national malaria control programmes (NMCPs). This raises serious difficulties in the standardization of methods and in obtaining international recognition of the standards reached by individual national programmes.
The need for quality assured malaria diagnosis cannot be over-emphasized with the threatening expansion of multi-drug resistant Plasmodium falciparum, introduction of newer treatments and lowering parasitemia in areas moving towards malaria elimination. On both end of the spectrum of malaria, greater and improved microscopy skills is a must – especially at the peripheral health services – stressing the importance for improved management, supervision, quality assurance and quality control.
In order to facilitate the process of development or strengthening of the QAS for malaria microscopy, ACTMalaria with the support from WHO-WPRO and SEARO, AAMI, RITM, AUSAID and USAID, has coordinated the conduct of external competency assessments (ECA) in the countries in the two WHO regions since 2005. All ACTMalaria member states and countries in the Pacific have already undergone the assessment, certification based on agreed grading scheme during the “Informal Consultation on QA of Microscopy – Microscopists and Slide Validation Schemes” held in Geneva in March 2006 and February 2008 and modelled after the first ECA conducted in the Philippines.
Although much effort has been put in by the National Malaria Programmes and their various technical and donor partners to upgrade the quality of microscopy thru provision of microscopes, laboratory supplies, training/re-training and supportive supervision, much more need to be done to ensure the quality of training / re-training and supervision, and to revitalize the quality assurance system for malaria microscopy in some of the countries where the QAS are still a bit far from ideal. For this purpose, relevant diagnosis policies and Standard Operating Procedures will have to be developed, updated and implemented with strong technical and managerial support.
To harmonize the developments in the countries’ QAS and as a follow-through of the QA Planning conducted in 2011 and ECAs conducted in the countries since 2005, a Planning Workshop on Strengthening Quality Assurance (QA) of Malaria Microscopy is proposed with the aim to develop a plan for further improvement of the existing routine QA system for Giemsa malaria microscopy in the countries.
The objectives of this workshop are:
1. Provide an overview of the structural components of Laboratory Quality Management System (LQMS) and Quality Assurance System (QAS) for Malaria Microscopy;
2. Identify strengths and weaknesses and remaining gaps in the existing QAS in the countries based on the standard tool for assessing capacity of national QAS and plans developed by the programs in 2011;
3. Develop systems for internal QA (cross-checking) appropriate to the different situations and conditions;
4. Develop a SOP for Parasite Counting and for conducting a national competency assessments;
5. Discuss and demonstrate how to establish a national reference slidebank for malaria;
6. Develop action plan to strengthen quality assurance in malaria microscopy.
At the end of the workshop, the participants would have agreed to develop and finalize the following :
1. Standardized QAS capacity assessment tool
2. List of Regional Laboratories to Perform EQA for Malaria Microscopy
3. SOP for Parasite Counting
4. Essential Requirements for Setting up a National Proficiency Assessment
5. Action Plan to Strengthen Country QAMM
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