Table 4.
Individual and institutional characteristics associated with accurate malaria microscopy diagnosis in surveyed health facilities in malaria low-transmission areas of Kenya, 2014
| Characteristic | Slides n (%) | Accurate diagnosis n (%) | Unadjusted | Adjusted | |||
|---|---|---|---|---|---|---|---|
| Prevalence ratio | 95% confidence interval | Prevalence ratio | 95% confidence interval | ||||
| Individual | |||||||
| Recent microscopy refresher training | No | 295 (39.0) | 197 (66.8) | 1.00 (Ref) | 1.00 (Ref) | ||
| Yes | 461 (61.0) | 446 (96.7) | 40.5 | 15.1–108.6 | 13.8 | 4.6–41.4 | |
| More than diploma-level initial training | No | 141 (18.7) | 109 (77.3) | 1.00 (Ref) | |||
| Yes | 615 (81.3) | 534 (86.8) | 2.1 | 0.9–4.6 | |||
| ≥5 years of work experience | No | 137 (18.1) | 78 (56.9) | 1.00 (Ref) | 1.00 (Ref) | ||
| Yes | 619 (81.9) | 565 (91.3) | 23.7 | 9.7–57.6 | 3.8 | 1.5–9.9 | |
| Worked in malaria high-transmission area | No | 383 (50.7) | 290 (75.7) | 1.00 (Ref) | |||
| Yes | 373 (49.3) | 353 (94.6) | 12.1 | 5.2–28.3 | |||
| Knowledge of malaria diagnostic and treatment guidelines | No | 194 (25.7) | 119 (61.3) | 1.00 (Ref) | |||
| Yes | 562 (74.3) | 524 (93.2) | 25.6 | 10.4–62.9 | |||
| Knowledge of malaria epidemiology in county | No | 94 (12.4) | 45 (47.9) | 1.00 (Ref) | |||
| Yes | 662 (87.6) | 598 (90.3) | 22.8 | 8.7–60.3 | |||
| Knowledge of malaria cases importation | No | 63 (8.3) | 20 (31.7) | 1.00 (Ref) | |||
| Yes | 693 (91.7) | 623 (89.9) | 21.1 | 7.2–62.1 | |||
| Institutional | |||||||
| Quality-assurance pilot programme | No | 378 (50.0) | 292 (77.2) | 1.00 (Ref) | 1.00 (Ref) | ||
| Yes | 378 (50.0) | 351 (92.8) | 6.0 | 1.9–18.9 | 4.3 | 1.0–11.0 | |
| Good optical condition of microscope(s) | No | 72 (9.5) | 46 (63.9) | 1.00 (Ref) | |||
| Yes | 684 (90.5) | 597 (87.3) | 7.6 | 1.1–51.4 | |||
| Rural location | No | 505 (66.8) | 415 (82.2) | 1.00 (Ref) | |||
| Yes | 251 (33.2) | 228 (90.8) | 2.7 | 0.7–10.1 | |||
| Participation in SLIPTA program | No | 647 (85.6) | 539 (83.3) | 1.00 (Ref) | |||
| Yes | 109 (14.4) | 104 (95.4) | 4.8 | 0.8–28.8 | |||
| >3 laboratory staff | No | 361 (47.8) | 308 (85.3) | 1.00 (Ref) | |||
| Yes | 395 (52.2) | 335 (84.8) | 1.1 | 0.3–3.3 | |||
| Hospital-level facility | No | 432 (57.1) | 376 (87.0) | 1.00 (Ref) | |||
| Yes | 324 (42.9) | 267 (82.4) | 0.8 | 0.2–2.5 | |||
| Workload >10 slides per day | No | 269 (35.6) | 239 (88.8) | 1.00 (Ref) | |||
| Yes | 487 (64.4) | 404 (83.0) | 0.6 | 0.2–2.1 | |||
Italic denotes statistical significance; recent training was defined as in the year prior to the survey
SLIPTA stepwise laboratory improvement towards accreditation, sponsored by World Health Organization; Ref reference