Quality and Quantitative Assessment of the Biological Diagnosis of Malaria in Children Aged 0 to 5 years in Two Health Facilities in Yaounde

Background and Objective: Malaria is a common life-threatening disease in Africa, particularly in Cameroon. It is one of the leading causes of mortality and morbidity in children, with over 13% of deaths occurring in children under the age of 5. Accurate and timely biological diagnosis of malaria in health facilities is essential for appropriate treatment. Therefore, this study was aimed to evaluate the quality of malaria diagnosis in children aged 0 to 5 years in two laboratories in some of these health facilities. Material and Methods: Across-sectional study was conducted in the laboratories of some public hospitals in Yaounde, CentreRegion of Cameroon from October 2021 to August 2022. The study focused on laboratory technicians, where we used a checklist to observe and noted their practices on biological diagnosis of malaria, by RDT and microscopy. We proceeded with same blood sample to analyze for malaria diagnosis according to World Health Organization (WHO) and national malaria control program (NMCP) in Cameroon’s guides. At the end, our findings were compared with the findings of the laboratory technicians. Results: Numerous errors were observed in the malaria diagnostic process at the different laboratories of these health facilities. These included the absence of clinical information on requisition forms, the analyses turnaround time of one hour was not respected, the recommended volume of blood to perform the thick and thin smear were not respected, non-application of the formula for the calculation of parasite density, and the non-identification of plasmodial species and the parasite stage. The material/reagents for diagnosis were of bad quality and no microscope maintenance with dirty lenses. We found that the causes to the errors identified were that: (1) The technicians had not had a formal training on malaria diagnosis in the previous months/years, (2) lack of quality material, appropriate microscope and supplies, (3) there were no current and ongoing programs of quality control, quality assessment (Proficiency Testing (PT) or External Quality Assessment (EQA)). At the end of our findings, we proposed some corrective actions with the immediate being a formal training on the national and WHOdirectives on malaria diagnosis and enrolment to a PT/EQA programon malaria diagnosis. Conclusion: Some errors caused people to suffer wrong diagnosis, wrong treatment and bad outcomes. Enrolment of these laboratories to PT/EQA programs are very important in helping the laboratories improve.