Table 1.
Composition of the external quality assessment and scores for each photograph and multiple choice question (MCQ-scores)
| Photograph | Lines present | Possible options given for the multiple choice questions | Comments | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| C | Pan | P.f. | 1. Invalid | 2. Negative | 3. Positive P.f. | 4. Positive, P.f. mixed infection possible | 5. Positive, P. non - falciparum | 6. Positive, but species not known | ||
| A | + | - | F | 6.9 | 29.1 | 54.8 | 3.0 | 1.7 | 4.5 | Faint line (P.f.-HRP2) intensity read or interpreted as negative: 29.1% |
| B | + | - | - | 5.2 | 90.0 | 2.6 | 0.4 | 0.7 | 1.0 | Missing negative test: 10.0% |
| C | - | - | - | 91.6 | 6.1 | 0.9 | 0.6 | 0.3 | 0.4 | Missing invalid test (no control line, no test line): 8.4% |
| D | + | F | S | 5.1 | 1.5 | 24.3 | 65.7 | 1.3 | 2.1 | Faint line (pLDH) intensity read or interpreted as negative: 24.3% |
| Failure to distinguish presence of P.f.: 1.3% + 2.1% = 3.4% | ||||||||||
| E | + | - | - | 6.5 | 87.6 | 2.1 | 1.8 | 1.0 | 1.0 | Missing negative test: 12.4% |
| F | + | - | W | 3.9 | 3.3 | 82.8 | 3.0 | 3.2 | 3.8 | Failure to distinguish presence of P.f.: 3.2% + 3.8% = 7.0% |
| Incorrect reading as negative: 3.3% | ||||||||||
| G | + | F | - | 6.4 | 7.2 | 6.1 | 4.7 | 70.7 | 4.9 | Faint line (Pan-pLDH) intensity read as negative = 7.2% |
| Wrongly interpreted as P.f.: 6.1% + 4.7% = 10.8% | ||||||||||
| H | + | - | M | 3.5 | 1.5 | 85.9 | 4.4 | 2.9 | 1.8 | Medium line (P.f.-HRP2) intensity read or interpreted as negative = 1.5% |
| Failure to distinguish presence of P.f.: 2.9% + 1.8% = 4.7% | ||||||||||
| I | + | S | S | 2.0 | 0.6 | 4.1 | 89.9 | 1.1 | 2.3 | Failure to distinguish presence of P.f.: 1.1% + 2.3% = 3.4% |
| J | - | - | S | 76.4 | 6.6 | 7.4 | 1.0 | 1.0 | 7.6 | Missing invalid test; No control line, presence of test line: 23.6% |
The MCQ-scores present the percentage of health workers (n = 2344) who correctly replied. See Figure 1 for the picture of the photographs. Correct answers are displayed in bold.
Abbreviations and symbols: C control line, Pan Plasmodium spp. (all four species), P.f. Plasmodium falciparum, − negative (no line present), + positive (visible control line present), F faint positive line intensity compared to the control line, M medium positive line intensity compared to the control line, W weak positive line intensity compared to the control line, S strong positive line intensity compared to the control line.