External Quality Assessment in the Examination of Blood Films for Malarial Parasites Within Ontario, Canada

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Abstract
Objective.—To assess laboratory practice in the examination of blood films for malarial parasites. Method.—Ontario medical laboratories, licensed by the Ministry of Health, are required to participate in external quality assessment by the Laboratory Proficiency Testing Program, which assesses performance of laboratory assays and also examines the total testing process. Educational strategies are used to improve performance. Results.—A 1995 survey indicated shortcomings in detection and identification of malarial parasites in blood films. Consequently, recommendations for the investigation of malarial parasites in blood were issued. In 1996 and 1997, 16 workshops were conducted. A 1997 follow-up external quality assessment survey indicated that problems persist as 27% of laboratories failed to correctly speciate Plasmodium falciparum. Good Practice Guidelines were issued in 1998. Conclusion.—Further education and assessment are required. Laboratories lacking expertise must establish referral arrangements with more proficient laboratories.

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