[An educational intervention to improve the quality of coproparasitological diagnosis in laboratories of Havana City, Cuba] / Intervención educativa para mejorar la calidad del diagnóstico coproparasitológico en la red de salud de Ciudad Habana, Cuba

The aim of this study was to evaluate the effectiveness of an educational program carried out in 1993. The intervention took place after the first external quality assessment in coproparasitology, conducted in 77 laboratories of Havana City. Centers receiving training were compared with those that did not, and better results were obtained in the municipalities of 10 de Octubre, Plaza, and Cerro, as well as in all laboratories that sent people to training. Better diagnosis was found for the helminths Trichuris trichiura, Taenia sp., and Fasciola hepatica as well for the protozoans Blastocystis hominis and Endolimax nana in the laboratories that received training. The laboratories that received training had significantly higher scores than those which did not. The results point to the effectiveness of the educational intervention. We recommend external quality assessment in coproparasitology as well as ongoing, mandatory technical education, held at regular intervals. Such measures should assure steady improvement in diagnosis of intestinal parasites by the health services network.

[External quality assessment in coproparasitology in Havana City Province, Cuba] / Control de la calidad del diagnóstico coproparasitológico en la provincia de Ciudad de La Habana, Cuba.

An external quality assessment in coproparasitology was carried out in 77 laboratories from Havana City. A questionnaire and ten plastic vials with different intestinal parasites in a small nylon bag, duly sealed, were sent to each laboratory. Answers were collected during the 72 hours after delivery. Results were analyzed by means of a computer program. The majority of the laboratories (70%) passed the test; the municipalities with the worst scores in the province were Lisa, Marianao, and Habana del Este. Better results were obtained among technologists working only in parasitology than those who were also performing other laboratory work, and better averages were observed in hospitals than in polyclinics. The best identified intestinal protozoan was Giardia lamblia and the worst identified was Blastocystis hominis (with a 61% mistake rate), followed by Endolimax nana (24.6%), and Entamoeba histolytica (22%). Among helminths, the best identified was Trichuris trichiura (9.2% mistake rate) and the highest percentage of incorrect diagnoses was for Taenia sp. and Fasciola hepatica (both with 66.2%). Taking into account these results, we feel it is necessary to provide training in parasitology among these laboratories.