External quality assessment of malaria microscopy in the Democratic Republic of the Congo

<p>Abstract</p> <p>Background</p> <p>External quality assessments (EQA) are an alternative to cross-checking of blood slides in the quality control of malaria microscopy. This study reports the findings of an EQA of malaria microscopy in the Democratic Republic of the Congo (DRC).</p> <p>Methods</p> <p>After validation, an EQA slide panel and a questionnaire were delivered to diagnostic laboratories in four provinces of DRC. The panel included three samples for diagnosis (sample 1: <it>Plasmodium falciparum</it>, 177,000/μl, sample 2: <it>P. falciparum</it>, 2,500/μl, sample 3: no parasites seen), one didactic sample (Howell-Jolly bodies) and one sample for assessing the quality of staining. Participating laboratories were addressed and selected through the network of the National Tuberculosis Control Programme. Participants were asked to return the responses together with a stained thin and thick blood film for evaluation of Giemsa stain quality.</p> <p>Results</p> <p>Among 174 participants (response rate 95.1%), 26.2% scored samples 1, 2 and 3 correctly and 34.3%, 21.5% and 5.8% of participants reported major errors in one, two or three samples respectively. Major errors included reporting "no malaria" or "non-<it>falciparum </it>malaria" for <it>Plasmodium falciparum</it>-positive samples 1 and 2 (16.1% and 34.9% of participants respectively) and "<it>P. falciparum</it>" for <it>Plasmodium </it>negative sample 3 (24.0%). Howell-Jolly bodies (didactic sample) were not recognized by any of the participants but reported as "<it>P. falciparum</it>" by 16.7% of participants. With parasite density expressed according to the "plus system", 16.1% and 21.5% of participants scored one "+" different from the reference score for samples 1 and 2 respectively and 9.7% and 2.9% participants scored more than two "+" different. When expressed as counts of asexual parasites/μl, more than two-thirds of results were outside the mean ± 2SD reference values. The quality of the Giemsa stain was poor, with less than 20% slides complying with all criteria assessed. Only one quarter of participants purchase Giemsa stain from suppliers of documented reliability and half of participants use a buffered staining solution. One third of participants had participated in a formal training about malaria diagnosis, half of them earlier than 2007.</p> <p>Conclusion</p> <p>The present EQA revealed a poor quality of malaria microscopy in DRC.</p

ANALYSE ENVIRONNEMENTALE ET SOCIALE DE L’ETAT DE LIEU DES INONDATIONS A KINSHASA. CAS DES QUARTIERS YOLO-NORD ET KIMBANGU I DANS LA COMMUNE DE KALAMU

Cette étude sur l’analyse environnementale et sociale de l’état de lieu des Inondations à Kinshasa. Cas des quartiers Yolo-Nord et Kimbangu I dans la Commune de Kalamu donne une idée claire de la vulnérabilité de la population aux inondations et précarité dans laquelle la population de ces quartiers vit.&nbsp; Cet état dans lequel vit les sujets enquêtés, engendre des conséquences néfastes sur l’environnement biophysique, sur le plan économique et social. Pour bien mener nos investigations, nous avons utilisé la méthode d’observation directe sur terrain appuyée par la recherche documentaire, l’interview, l’enquête par questionnaire. Cette étude participe à la réduction et la prévention des risques particulièrement inondation sur l’environnement biophysique. Les résultats montrent que dans les quartiers Yolo-Nord et Kimbangu I, la majorité de population est vulnérable et vit dans une situation dangereuse des inondations à chaque pluie diluvienne qui tombe. Le manque d’entretien de la rivière et l’absence des caniveaux dans les avenues ainsi que l’obstruction des drains existants, viennent aggraver cette situation dans les zones sous étude. La prévention des risques exige la mise en place d’un mécanisme ou d’un dispositif d’alerte précoce, d’un système de drainage adéquat et ce système doit être particulièrement sensible au danger