Development and Evaluation of an Online Proficiency Testing System for Malaria Microscopy Diagnosis using Digital Blood Film Photography Innovation
Keywords:
Malaria, Proficiency testing, Microscopy diagnosisAbstract
This research aimed to develop and evaluate an online proficiency testing system for microscopic malaria diagnosis, utilizing digital photography innovations of actual blood films, and to assess the agreement between the online and conventional assessment methods. The sample consisted of 94 laboratory personnel assessed by the conventional method and 134 participants assessed by the online method. Nine standardized blood film cases, validated by WHO-certified level 1 and level 2 experts and confirmed by Real-time PCR, were used as test materials. Data were analyzed using one-way ANOVA, paired t-test, and Bland-Altman plot. The results showed that the conventional method yielded mean percentages of 84.75, 97.40, and 70.39 for parasite identification, parasite detection, and parasite counting, while the online method showed 81.96, 97.14, and 78.78, respectively. Paired t-test analysis revealed p-values of 0.53, 0.78, and 0.06 for the three competencies, respectively, indicating no statistically significant differences (p>0.05). Bland-Altman analysis demonstrated that parasite detection exhibited the highest agreement with a bias of 0.26 and limits of agreement ranging from -5.15 to 5.66. User satisfaction averaged 90 percent. The study concludes that the online proficiency testing system, utilizing digital blood film photography, is an effective alternative to the conventional method. It is an appropriate tool for assessing laboratory network personnel with increased coverage, which can enhance the quality assurance system for microscopic malaria diagnosis to support Thailand's malaria elimination goals.
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