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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Establishing a malaria diagnostics centre of excellence in Kisumu, Kenya
Malaria Journal, Volume 6, Article 79, Year 2007
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Description
Background. Malaria microscopy, while the gold standard for malaria diagnosis, has limitations. Efficacy estimates in drug and vaccine malaria trials are very sensitive to small errors in microscopy endpoints. This fact led to the establishment of a Malaria Diagnostics Centre of Excellence in Kisumu, Kenya. The primary objective was to ensure valid clinical trial and diagnostic test evaluations. Key secondary objectives were technology transfer to host countries, establishment of partnerships, and training of clinical microscopists. Case description. A twelve-day "long" and a four-day "short" training course consisting of supervised laboratory practicals, lectures, group discussions, demonstrations, and take home assignments were developed. Well characterized slides were developed and training materials iteratively improved. Objective pre- and post-course evaluations consisted of 30 slides (19 negative, 11 positive) with a density range of 50-660 parasites/μl, a written examination (65 questions), a photographic image examination (30 images of artifacts and species specific characteristics), and a parasite counting examination. Discussion and Evaluation. To date, 209 microscopists have participated from 11 countries. Seventy-seven experienced microscopists participated in the "long" courses, including 47 research microscopists. Sensitivity improved by a mean of 14% (CI 9-19%) from 77% baseline (CI 73-81 %), while specificity improved by a mean of 17% (CI 11-23%) from 76% (CI 70-82%) baseline. Twenty-three microscopists who had been selected for a four-day refresher course showed continued improvement with a mean final sensitivity of 95% (CI 91-98%) and specificity of 97% (CI 95-100%). Only 9% of those taking the pre-test in the "long" course achieved a 90% sensitivity and 95% specificity, which increased to 61% of those completing the "short" course. All measures of performance improved substantially across each of the five organization types and in each course offered. Conclusion. The data clearly illustrated that false positive and negative malaria smears are a serious problem, even with research microscopists. Training dramatically improved performance. Quality microscopy can be provided by the Centre of Excellence concept. This concept can be extended to other diagnostics of public health importance, and comprehensive disease control strategies. © 2007 Ohrt et al; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC1933544/bin/1475-2875-6-79-S1.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC1933544/bin/1475-2875-6-79-S2.pdf
Authors & Co-Authors
Ohrt, Colin K.
United States, Silver Spring
Walter Reed Army Institute of Research
Obare, Peter
Kenya, Nairobi
Kenya Medical Research Institute
United States, Arlington
United States Army
Nanakorn, Ampon
Thailand, Bangkok
Armed Forces Research Institute of Medical Sciences, Thailand
Adhiambo, Christine A.
Kenya, Nairobi
Kenya Medical Research Institute
United States, Arlington
United States Army
Awuondo, Ken O.
Kenya, Nairobi
Kenya Medical Research Institute
United States, Arlington
United States Army
O'Meara, Wendy Prudhomme
United States, Bethesda
National Institutes of Health Nih
Remich, Shon A.
Kenya, Nairobi
Kenya Medical Research Institute
United States, Arlington
United States Army
Martin, Kurt
United States, Silver Spring
Walter Reed Army Institute of Research
Cook, Earnest
Kenya, Nairobi
Kenya Medical Research Institute
United States, Arlington
United States Army
Chretien, Jean Paul
United States, Silver Spring
Walter Reed Army Institute of Research
Lucas, Carmen M.
Peru, Lima
Naval Medical Research Unit No. 6
Osoga, Joseph
Kenya, Nairobi
Kenya Medical Research Institute
United States, Arlington
United States Army
McEvoy, Peter
United States, Arlington
United States Department of Defense
Owaga, Martin L.
Kenya, Nairobi
Kenya Medical Research Institute
Odera, James Sande
Kenya, Nairobi
Kenya Medical Research Institute
United States, Arlington
United States Army
Ogutu, Bernhards R.
Kenya, Nairobi
Kenya Medical Research Institute
United States, Arlington
United States Army
Statistics
Citations: 79
Authors: 16
Affiliations: 7
Identifiers
Doi:
10.1186/1475-2875-6-79
e-ISSN:
14752875
Research Areas
Infectious Diseases
Study Locations
Kenya