Table 1.
Steps in malaria microscopy performance evaluated on outreach training and supportive supervision checklist
| Procedure* | Score |
|---|---|
| Identifies patient and records patient information in register | ☐Yes ☐No |
| Wears gloves (count as yes if not available) | ☐Yes ☐No |
| Cleans slide | ☐Yes ☐No |
| Labels slide with date and patient’s name and/or number | ☐Yes ☐No |
| Used finger prick to collect blood | |
| Cleans finger with alcohol and allows to dry | ☐Yes ☐No |
| Pricks finger, wipes off the first drop of blood, and places subsequent drop on slide w/o touching finger | ☐Yes ☐No |
| Used venipuncture to collect blood | ☐Yes ☐No |
| Labels ethylenediaminetetraacetic acid collection tube with date and patient’s name and/or number | ☐Yes ☐No |
| Cleans puncture site with alcohol and allows to dry | ☐Yes ☐No |
| Assembles sterile needle and syringe or vacutainer | ☐Yes ☐No |
| Collects and gently mixes venous blood sample successfully | ☐Yes ☐No |
| Applies blood from only one patient to each thick film slide | ☐Yes ☐No |
| Spreads thick film into 1–2 cm diameter circle; can read print placed under the slide | ☐Yes ☐No |
| Air-dries thick film slide before staining | ☐Yes ☐No |
| Filters stain before use | ☐Yes ☐No |
| Used Giemsa stain | |
| Uses standard 10% Giemsa solution† | ☐Yes ☐No |
| Prepares fresh Giemsa staining solution properly or on the day of observation | ☐Yes ☐No |
| pH of the staining solution between 7.2 and 7.4 (count as yes if unable to check) | ☐Yes ☐No |
| Immerses thick film slide in 10% Giemsa stain for 10–15 minutes | ☐Yes ☐No |
| Rinses thick film slide carefully with water | ☐Yes ☐No |
| Used Field stain | |
| Prepares fresh Field stain A solution (methylene blue) properly or on the day of observation | ☐Yes ☐No |
| Prepares fresh Field stain B solution (eosin) properly or on the day of observation | ☐Yes ☐No |
| Immerses slide in stain A for 3 seconds | ☐Yes ☐No |
| Rinses slide carefully with water after using stain A | ☐Yes ☐No |
| Immerses slide in stain B for 5 seconds | ☐Yes ☐No |
| Rinses slide carefully with water after using stain B | ☐Yes ☐No |
| Drains and air-dries slide (avoiding application of external heat) | ☐Yes ☐No |
| Segregates and safely disposes off sharp waste in a safety box | ☐Yes ☐No |
| Disposes off infectious waste in appropriate waste containers | ☐Yes ☐No |
| Washes off/disinfects liquid waste appropriately | ☐Yes ☐No |
| Supervisor agrees with staff on slide result | ☐Yes ☐No |
* Checklist steps in bold (“minimum standard” steps) are considered more important and are collectively weighted twice as much as the other steps when calculating scores.
† Health facilities preferred to use the 10% Giemsa solution because of its rapid turnaround when compared with the 3% Giemsa solution.