By Rick Scavetta and Chris Thomas
Inside Rachuonyo district hospital in Kenya, Simba Mobagi peers through his laboratory’s only microscope at a sick woman’s blood sample. The 33-year-old laboratory technologist’s goal – rapidly identifying malaria parasites. Dozens more samples await his eyes. Each represents a patient suffering outside on wooden benches. Mogabi takes little time to ponder his workload. He quickly finds malaria parasites, marks his findings on a pink patient record and moves to the next slide.
For more than 40 years, U.S. Army Medical Research Unit-Kenya – locally as the Walter Reed Project – has studied diseases in East Africa through a partnership with the Kenya Medical Research Institute.
The Malaria Diagnostics and Control Center of Excellence in Kisumu, a unique establishment begun in 2004 has trained more than 650 laboratory specialists from more than a dozen countries across the African continent in malaria microscopy skills. Most of the center’s $450,000 annual budget comes from the U.S. President’s Malaria Initiative, led by USAID and implemented jointly with the Centers for Disease Control and Prevention (CDC). Other funding is from the U.S. Defense Department, NGOs and pharmaceutical companies.
For students to practice malaria identification, five Kenyan lab technicians work tirelessly to create a variety of blood specimens. Slides may show one or more of malaria’s several species – others are free of parasites. The majority of malaria cases are the falciparum species, but many people are co-infected with other species and it’s important for students to recognize. Lab students learn skills and habits that increase their ability to accurately detect malaria on blood slides. And by partnering with laboratory managers, we hope to increase standards and improve efficient and effective diagnosis. To mark progress, lab staffs must collect 20 slides each month that show properly handled blood samples. Monthly visits mark performance improvement.
PMI is collaborating with National Malaria Control Programs (NMCP) and other partners, such as the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the World Health Organization (WHO), to strengthen laboratory diagnosis of malaria. These efforts to upgrade laboratory services help improve the overall quality of primary health care, diagnosis, and treatment. In 2009 alone, PMI funded the training of more than 2,800 laboratory staff in microscopic and rapid diagnostic test (RDTs) diagnosis. Read more on PMI efforts.
Improving case management of malaria in African countries presents numerous challenges due to weak health systems. Health worker shortages, infrequent and ineffective training and supervision, weak supply chain management systems, and the lack of quality laboratory services greatly limit a country’s ability to deliver high-quality services for malaria and other childhood illnesses. The PMI support to the U.S Army Medical Research Unit in Kenya to train a new cadre of laboratory specialist to diagnose malaria is another step in the right direction of strengthening health systems in African countries.