External quality assessment in the examination of flood films for malarialparasites within Ontario, Canada

Objective.-To assess laboratory practice in the examination of blood films for malarial parasites. Method.-Ontario medical laboratories, licensed by the Ministry of Health, a re required to participate in external quality assessment by the Laboratory Proficiency Testing Program, which assesses performance of laboratory assa ys and also examines the total testing process. Educational strategies are used to improve performance. Results.-A 1995 survey indicated shortcomings in detection and identificati on of malarial parasites in blood films. Consequently, recommendations for the investigation of malarial parasites in blood were issued. In 1996 and 1 997, 16 workshops were conducted. A 1997 follow-up external quality assessm ent survey indicated that problems persist as 27 % of laboratories failed t o correctly speciate Plasmodium falciparum. Good Practice Guidelines were i ssued in 1998. Conclusion.-Further education and assessment are required. Laboratories lac king expertise must establish referral arrangements with more proficient la boratories.