Análise do controle de qualidade do diagnóstico da malária realizados por microscopistas do estado de Mato Grosso, Brasil, entre 2009 e 2011

Abstract

There is a malaria endemic in 109 countries around the world, and in Brazil the state of Mato Grosso corresponds to 0.67% of the total cases in the Amazon region. In order to identify the parasites, the examination of thick blood smear is done and it passes through quality control. First, they are examined at primary level laboratories, then they are reviewed by supervisors at intermediate level called Regional Health Services (RHS), and then they are reviewed again in central level at the reference state (Lacen/MT Laboratorio). Objective: To analyze the quality control, according to the disagreements, for the diagnosis of malaria microscopists performed in the state of Mato Grosso, Brazil, between 2009 and 2011. Methods: A descriptive cross-sectional study that used secondary data from reports of the laboratory diagnosis of malaria in the state of Mato Grosso between 2009-2011, and about aspects of human resources and structure and organization of review laboratories of Regional Health Services (RHS) that performs laboratory diagnosis of malaria in the state of Mato Grosso in the period 2009-2011. Results: In this period the regional microscopists of the RHS revised 38.72% of smears produced at primary level, finding a percentage of 1.92% of difference. The laboratory central supervisor from Lacen/MT Laboratory revised 82.53% of the slides reviewed by regional microscopists of RHS, finding a percentage difference of 1.62%. Differences of the laboratories base were related 36.82% to parasite species present or gametocytes, 32.34% to false positive and 30,85% to false negative. In the revision laboratories of RHS 55.38% of blood smears reviewed differences were related to the parasite species present or gametocytes, 19.23% were false positive and 25.38% were false negative. About the education, the regional microscopists of the RHS had highest proportion of disagreements in those who had high school. About the physical structure, internal organization and basic hygiene for primary level and to review laboratories, were considered from regular to good. Conclusion: Disagreements related to primary level microscopists were more often in those who had college degree, to regional microscopists of RHS the disagreements were greater in those who had lower education. The characteristics of the physical 4 structure, service organization and maintenance of laboratory equipment to the primary level laboratories were considered from regular to good. This study may be representative of the situation of malaria quality microscopy in the state of Mato Grosso, giving the opportunity to the Health Departments of the state and to the cities to look for improvements in this quality service.