Evaluation of Malaria Microscopy Proficiency Among Laboratory Scientists in Public Hospitals in Kano State

Quality malaria microscopy remains the reference diagnostic standard for treatment decisions and epidemiological surveillance, and laboratory scientist proficiency is a key determinant of diagnostic accuracy. This study evaluated malaria microscopy proficiency among laboratory scientists in public secondary and tertiary hospitals in Kano State, Northwest Nigeria. A total of 80 laboratory scientists from 20 health facilities participated in a competency assessment using standardised blood film panels prepared by the National Reference Laboratory. Panels included films with varying parasite densities, mixed species infections, and parasite-negative slides. Sensitivity, specificity, and species identification accuracy were calculated for each participant. Mean sensitivity across all participants was 76.4 percent and mean specificity was 81.9 percent, below the minimum standard of 90 percent recommended by WHO. Participants with over five years of experience significantly outperformed junior scientists. Facilities without ongoing external quality assurance participation showed the lowest proficiency scores. Only 31.3 percent of facilities had functional microscopy reference panels available. The study recommends reintroduction of structured external quality assurance programmes, mentored on-site training, and procurement of reference slide libraries for all public hospital laboratories in Kano State. Keywords: malaria microscopy, laboratory proficiency, external quality assurance, diagnostic accuracy, Kano State.