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ANDI Centre of Excellence for Malaria Diagnosis begins int’l course to build microscopy capacity in Africa

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The ANDI Centre of Excellence for Malaria Diagnosis, College of Medicine, University of Lagos (UNILAG), has identified one of the challenges of malaria diagnosis in health facilities. 

The Rector of the centre, Prof. Wellington Oyibo, made the disclosure at the opening of a 12-day International Intensive Malaria Certificate Course on Friday in Lagos.

The Nigeria News Agency reports that the certificate course is for Laboratory Technicians (Microscopists) drawn from health facilities from within and outside the country.

A total of 14 of the Microscopists, including those from Democratic Republic of Congo (DRC), Botswana and Zambia are participating in the programme.

According to him, there are current challenges in diagnosis of malaria, especially as the epidiomology of malaria continues to change.

Oyibo said that from mentorship experience of experts, following supervision on the job and malaria case management strengthening in public and private sectors, most malaria smears were likely to be reported as positive.

He said the specificity of the Microscopists were usually appalling, noting that this was indicative of poor capacity in malaria disgnosis given its specialised nature.

The don further noted that the 2018 World Malaria report had indicated that there was an increased malaria burden in several countries.

He said that it was therefore important that countries, institutions and related organisations build the capacity of their core malaria diagnosis personnel for national and global competitiveness.

“The primary aim of this certificate course in malaria diagnosis (with Microscopy and Rapid Diagnostic Tests) is to build the capacity of malaria Microscopists to strengthen and support national, state and organisational malaria diagnosis with excellence.

“Early disgnosis and prompt, effective treatment remains the basis for the management of malaria, as well as key in reducing malaria mortality and morbidity.

“Demonstrations of the presence of malaria parasites prior to treatment with anti-malaria drugs is fundamental to this goal, as clinical diagnosis has poor accuracy and leads to over-diagnosis of malaria with resultant poor management of non-malarial febrile illnesses and wastage of anti-malaria drugs,” he said.

According to him, while microscopy remains the main stay of parasite-based diagnosis in most large health clinics and hospitals, the quality of microscopy-based diagnosis is frequently inadequate in ensuring good health outcomes and optimal use of resources.

“An acceptable microscopy service is one that is cost effective, provides results that are consistently accurate and timely enough to have a direct impact on treatment.

“Malaria medicine use is unacceptable, thus dislocating opportunities for organisations to have value-for-money in malaria case management.

“The 2014 to 2015 National Malaria Strategic Plan for Nigeria is envisioned to have a malaria-free country by 2020 where we would have attained the pre-elimination phase with slide positivity rate below five per cent.

“In this plan, 80 to 100 per cent of febrile persons in both the public and private sector health facilities should be tested using a quality assured diagnostics (Microscopy or RDTs) by 2018/2020,” he said.

Oyibo assured the people that increased capacity for malaria diagnosis would improve best practices and above  all ensure that the cause of fever was explored, as malaria was not in most cases the sole contributor to febrile illnesses and manged effectively.

In his view, the Provost, College of Medicine, University of Lagos, Prof. Afolabi Lesi, said that malaria diagnosis was one of the key pillars of its prevention and control, adding that without accurate diagnosis, there would be no planned treatment.

“This is because not every fever is malaria and so, there is need for a right diagnosis to be able to treat malaria appropriately.

“I am indeed happy with what is going on here today. We have seen that malaria prevalence in the country has actually been dropping from the latest data we have.

“So ,clearly what we are doing is working and what this programme is trying to do is also to expand trainees across Africa and that is why participants are coming from other African countries, which will eventually improve the capacity across the continent in diagnosing  malaria effectively.

“Malaria is endemic in this part of the world, so it is easily believed that every fever  is likely to be malaria or typhoid and I think that perception has to change.

“We must insist on test before treatment because the standard now is to diagnose before treatment even if  it means using the Rapid Diagnostic Tests (RDTs) for those without the Microscopist skills,” he said.

Lesi lauded the ANDI  Centre of Excellence for Malaria Diagnosis for it’s landmark achievements over the years  in the management and control of the disease as well as putting the institution’s College of  Medicine in a shining spotlight.

(Editing by Peter Ejiofor)

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