Detection and Identification of Malaria Parasites: A Review of Proficiency Test Results and Laboratory Practices

Background This study assesses proficiency test (PT) performance in detecting and identifying malaria parasites and examines malaria screening practices in laboratories in the United States Method We reviewed PT data from 1999 to 2008 to determine the rates of unacceptable responses for detecting and identifying Plasmodium sp We also surveyed current PT participants to assess malaria screening practices Results Laboratories were most proficient at detecting and identifying P falciparum and substantially less proficient at identifying P malariae, P vivax and P ovale Half of the surveyed laboratories failed to offer a complete diagnostic workup 25 0% failed to screen both thick and thin slides, and 36 1% failed to issue a final report within 24 hours Conclusion Educational programs should focus on identifying Plasmodium sp and distinguishing artifacts from parasites Laboratories should offer a complete diagnostic workup, either in house or by referral and ensure final results within 24 hours