Evaluation of Malaria Microscopy Diagnosis Performance in Public Hospitals of Eastern and Central Part of Oromia Region, Ethiopia, 2019

Back ground: Prompt and accurate malaria diagnosis is essential strategies for effective malaria case management as well as the public health response to malaria. Diagnosis based on clinical grounds alone may lead to misdiagnosis and mistreatment. The objective of this study is to evaluate the performance of malaria microscopy diagnosis public hospitals of Eastern and Central part Oromia, Ethiopia Method : Hospital based cross sectional study was conducted from March, 2019 to May, 2019. All 46 public hospitals of 12 zones in Eastern and Central parts of Oromia, Ethiopia were included in the study. Data were collected using Semi structured questionnaire and known validated positive and negative slides with different species, stage and parasite density distributed to each health facility. It was categorized and cleaned by Epi Info version 3.5.1 and analyzed by SPSS version 20 with multivariate analysis to identify factors associated with poor malaria microscopy diagnosis. Level of agreement was calculated by Kappa statistics. Results: From the total of 46 hospitals , 31 (67.39%) had acceptable quality performance with cumulative grading score of > 80%. The overall percentage of agreement in detection and species identification was 80.45% (Kappa=0.79) and 63.03% (Kappa=0. 38). Laboratory professionals who had work experience greater than five years were 10.56 times better in detecting and identifying malaria parasite when compared to those who had work experience less than or equal to five years (AOR [95%CI]=10.56[1.45-76.73]) . Laboratory professionals who were trained on malaria microscopy diagnosis were 1.28 times reported better quality results than those who were not trained (AOR, % 95CI=1.28[1.5-48.13]) Conclusion: The overall agreement of laboratory professionals in detection and species identification was with substantial and fair with kappa value 0.79 and 0.38 respectively. There were also gaps in correctly reporting stages identification and parasite count from distributed slides. Lack of Training and low work experience of laboratory professionals were factors associated with malaria microscopy diagnostic performance. Hence, capacitating laboratory professionals is essential to ensure good performance of malaria microscopy which reduces misdiagnosis of malaria parasites and mistreatment of malaria suspected patients.