In the pursuit of eliminating malaria, an “External Competence Assessment of Malaria Microscopists (ECAMM)” was organized in Thailand from 22-25 May and 29 May-2 June. The assessment was organized by the World Health Organization (WHO) Thailand, in collaboration with Thailand’s Division of Vector-Borne Disease (Department of Disease Control, Ministry of Public Health), and with the support of USAID-PMI. Mr. Sherwin Galit, the WHO ECAMM Facilitator from WHO-Collaborating Centre, Research Institute for Tropical Medicine Philippines, led the assessment. This assessment aimed to ensure accurate and reliable results in the microscopic malaria diagnosis, which contributes to optimizing disease management and elimination. Microscopy remains the gold standard for malaria diagnosis.
Uniting Our Expertise: WHO Malaria Microscopy Assessment brings together two dedicated batches being assessed, exemplifying a commitment to combating malaria. © WHO Thailand 2023
In 2003, a global competency assessment model for microscopists was developed to address shortfalls in parasite detection, species identification and parasite quantification. As each of these elements has consequences on patients’ treatment, the assessments aim for improvements in each of these areas, identifying what support is needed, and thus how to enhance malaria diagnosis and contribute to standardizing personnel competencies, which help to overcome inconsistencies in diagnosis and improve disease management. The WHO ECAMM certification of a microscopist, which has a 3-year validity, requires regular assessments for recertification and assess new laboratory personnel. Top-performing Level 1 and 2 participants become trainers and validators in reference or subnational laboratories.
Ms Auravee Indar, a first-time ECAMM participant and Medical Technologist of ODPC 8 from Udon Thani in Northeast Thailand, expressed how beneficial this assessment was in enhancing her laboratory proficiency, particularly decision-making abilities as an expert. She emphasized the importance of making accurate and effective decisions for patients and believes that this assessment has equipped her with the necessary skills. Ms Auravee now feels highly confident about having met the ECAMM standards, as the ECAMM certification is very useful since the ODPC 8 recently opened a lab under the Immigration Division, serving seven provinces in Region 8.
The ECAMM is being implemented globally across WHO regions, establishing a multi-regional network for quality assurance in malaria microscopy. Moreover, it has successfully adapted to changing malaria control efforts and has been implemented in various countries through collaboration with health authorities and local institutions. Dr Aungkana Saejeng, Senior Public Health Technical Officer in ODPC 1, located in Chiang Mai, North of Thailand, brings 25 years of malaria experience and has been involved in ECAMM since 2010. She recognizes the challenge of accurate parasite counting and believes in ECAMM's ability to evaluate expertise. She said the certificate not only boosts confidence but also facilitates hospital networking, emphasizing on the risks of hospital misdiagnoses due to outdated skills and non-compliance with WHO Malaria Microscopy Quality Assurance (QA) guidelines, as ECAMM certification encourages hospital laboratories to collaborate for quality assurance. Furthermore, she proposes to expand ECAMM to universities for future adoption by laboratory technicians.
The ECAMMs are crucial for quality control, standardizing diagnostic practices, and building confidence in malaria diagnosis. WHO and partners such as USAID-PMI and MoPH aim to accelerate malaria elimination and improve program efficiency by ensuring healthcare professionals' competence. The WHO ECAMM remains an indispensable tool in the fight against malaria, driving accurate diagnosis, enhancing patient care, and advancing global efforts for a malaria-free future, consistent with the WHO's commitment to quality patient care and a disease-free world.
Focused on the test: “Peering into the World of the Malaria Parasite” during the WHO ECAMM in Thailand © WHO Thailand 2023