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Abstract：
BACKGROUND: Qualified malaria diagnosis competency has contributed to the great achievement of malaria elimination in China. After eliminating malaria, it is still critical to the prevention of re-establishment of malaria transmission in China. This study was aimed to assess the malaria detection competency at national and provincial levels in China at the beginning of malaria post-elimination phase.
METHODS: In the present study, different competency assessment activities on the laboratory malaria diagnosis were carried out for national and provincial malaria diagnostic laboratories based on the WHO scoring schedules, including malaria microscopy or nucleic acid amplification tests (NAAT), at the beginning of malaria post-elimination phase (2021-2022) in China.
RESULTS: A total of 60 slides for malaria microscopy and 10 specimen for NAAT were included into the WHO External Quality Assessments of malaria parasite qualitative detection and species identification, and the scoring rate was 96.6% (microscopy: 171/177) and 85.0% (NAAT: 17/20), respectively. Moreover, 124 samples were included into the national NAAT quality assessment, and an accuracy of 87.9% (109/124) was found without significance among reference laboratories and non-reference laboratories.
CONCLUSIONS: The findings suggest that there is still a need for sustained strengthening of malaria detection competency, particularly in the areas of parasite counting and detection of low-density parasitemia, to ensure prompt detection of the sources of infection and accurate identification of Plasmodium species, and contribute to case management and focus disposal, thereby effectively preventing the malaria re-establishment.
METHODS: In the present study, different competency assessment activities on the laboratory malaria diagnosis were carried out for national and provincial malaria diagnostic laboratories based on the WHO scoring schedules, including malaria microscopy or nucleic acid amplification tests (NAAT), at the beginning of malaria post-elimination phase (2021-2022) in China.
RESULTS: A total of 60 slides for malaria microscopy and 10 specimen for NAAT were included into the WHO External Quality Assessments of malaria parasite qualitative detection and species identification, and the scoring rate was 96.6% (microscopy: 171/177) and 85.0% (NAAT: 17/20), respectively. Moreover, 124 samples were included into the national NAAT quality assessment, and an accuracy of 87.9% (109/124) was found without significance among reference laboratories and non-reference laboratories.
CONCLUSIONS: The findings suggest that there is still a need for sustained strengthening of malaria detection competency, particularly in the areas of parasite counting and detection of low-density parasitemia, to ensure prompt detection of the sources of infection and accurate identification of Plasmodium species, and contribute to case management and focus disposal, thereby effectively preventing the malaria re-establishment.
摘要：
背景：合格的疟疾诊断能力为中国消除疟疾的巨大成就做出了贡献。消灭疟疾后,在中国，预防疟疾传播的重建仍然至关重要。本研究旨在评估疟疾消除后阶段开始时中国国家和省级的疟疾检测能力。
方法：在本研究中，根据世卫组织评分表，对国家和省级疟疾诊断实验室开展了不同的疟疾诊断能力评估活动，包括疟疾显微镜或核酸扩增测试（NAAT），在中国疟疾消除后阶段（2021-2022年）开始时。
结果：共60张疟疾显微镜载玻片和10份NAAT标本被纳入世卫组织疟疾寄生虫定性检测和物种鉴定的外部质量评估，得分率分别为96.6%(显微镜:171/177)和85.0%(NAAT:17/20),分别。此外，124个样本被纳入国家NAAT质量评估，在参考实验室和非参考实验室中，发现准确率为87.9％（109/124），但无统计学意义。
结论：研究结果表明，仍然需要持续加强疟疾检测能力，特别是在寄生虫计数和低密度寄生虫血症检测领域，为了确保迅速检测感染源和准确识别疟原虫物种，并有助于案件管理和重点处置，从而有效防止疟疾的重新建立。
方法：在本研究中，根据世卫组织评分表，对国家和省级疟疾诊断实验室开展了不同的疟疾诊断能力评估活动，包括疟疾显微镜或核酸扩增测试（NAAT），在中国疟疾消除后阶段（2021-2022年）开始时。
结果：共60张疟疾显微镜载玻片和10份NAAT标本被纳入世卫组织疟疾寄生虫定性检测和物种鉴定的外部质量评估，得分率分别为96.6%(显微镜:171/177)和85.0%(NAAT:17/20),分别。此外，124个样本被纳入国家NAAT质量评估，在参考实验室和非参考实验室中，发现准确率为87.9％（109/124），但无统计学意义。
结论：研究结果表明，仍然需要持续加强疟疾检测能力，特别是在寄生虫计数和低密度寄生虫血症检测领域，为了确保迅速检测感染源和准确识别疟原虫物种，并有助于案件管理和重点处置，从而有效防止疟疾的重新建立。
