The reliability of blood film examination for malaria at the peripheral health unit

Background: Malaria is a common and serious problem in Ethiopia. Blood film examination is the best tool for diagnosing malaria where feasible. Objective: To assess the reliability of blood film examination at the primary health care level. Method: Two specimens were taken from all suspected patients in five health center and one hospital in north Gondar zone in Ethiopia. One to be stained and read by the operational readers, the other to be sent unstained to the reference reader. Result: Out of 3625 patients whose blood film was sent, 44% were females and 28% were positive for malaria. The peak age was 15-29. The proportion of P. falciparum and P. vivax was 64.6% and 35.6%. The specificity and positive predictive values were low and the overall chance corrected agreement (kappa score) of the operational and reference reader was less than 0.53. Conclusion and recommendation: The agreement and species identification of the operational and reference readers were low. Continuous retraining and supervision are indispensable. Ethiop.J.Health Dev. 2003;17(3):197-204