Abstract

PEREIRA, Maria da Paz Luna; IGUCHI, Takumi  and  SANTOS, Elizabeth Glória Oliveira Barbosa dos. Evaluation of discordant results using thick blood smears for the diagnosis of malaria in the brazilian states of Amapá and Maranhão, 2001 to 2003. Epidemiol. Serv. Saúde [online]. 2006, vol.15, n.2, pp.35-45. ISSN 1679-4974.  http://dx.doi.org/10.5123/S1679-49742006000200005.

Local malaria laboratories are required to send 100% and 10% of positive and negative slides, respectively, to reference laboratories. The objective of this study was to evaluate the discrepancies between the results of thick blood smears evaluated by reference laboratories and results reported by local technicians in Amapá and Maranhão States, Brazil during the period 2001 to 2003. The following methodologies were utilized: Epi Info version 6.04 and 2000 software for data analysis; both Kappa index and χ² test, to compare results; and uni-and multivariate analysis to detect variables associated with discrepancies. A higher discrepancy index was observed in Amapá (1.72%) compared to Maranhão (0.43%), with more difficulty in species identification - 1.88% versus 0.37%, respectively. Amapá had a higher false negative index (0.60%); and Maranhão had a higher false positive (0.12%). Training courses were more efficient in Maranhão. In the multivariate analysis, variables for Brazilian State and length of technician's experience were most strongly associated with the discrepancies identified. Training courses and quality control among laboratories are essential for the National Program for Malaria Control.

Keywords : malaria; diagnosis; quality control.

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