{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T10:23:49Z","timestamp":1776335029320,"version":"3.51.2"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T00:00:00Z","timestamp":1695859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The provincial malaria diagnosis reference laboratories review and assess malaria cases diagnosed in health facilities for supporting the malaria elimination efforts and preventing re-transmission of imported malaria. The study aimed to evaluate the detection capability of malaria diagnosis in China from 2014 to 2021.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data on malaria cases reported in the provincial-level administrative divisions (PLADs) of Anhui, Henan, Hubei, Guangxi, and Zhejiang from 2014 to 2021 were collected and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 5,770 malaria cases were reported from 2014 to 2021, and 99.05% (5,715\/5,770) were submitted to the provincial malaria diagnosis reference laboratories. The median time between malaria cases being reported and the samples being received by reference laboratories was 6\u2009days (Interquartile range, IQR:3\u201312\u2009days) from 2017 to 2021. Diagnosis of 5,680 samples in the laboratory were confirmed by provincial reference laboratories, including 3,970 cases of <jats:italic>Plasmodium falciparum<\/jats:italic>, 414 of <jats:italic>P. vivax<\/jats:italic>, 1,055 of <jats:italic>P. ovale<\/jats:italic>, 158 of <jats:italic>P. malariae<\/jats:italic>, 1 of <jats:italic>P. knowlesi<\/jats:italic>, and 82 of mixed infections. <jats:italic>Plasmodium<\/jats:italic> species of 5,141 confirmed cases were consistent with the initial diagnosis, with a species accuracy rate of 90.53% (5,141\/5,679). The accuracy of <jats:italic>P. falciparum<\/jats:italic> diagnosis in health facilities was higher than that of non-falciparum species. The inconsistency between microscopy and nested polymerase chain reaction (nPCR) results of confirmatory diagnosis was mainly in malaria-positive versus malaria-negative cases, as well as in mixed versus single infection cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The provincial malaria diagnosis reference laboratories have played an important role in ensuring the accuracy and reliability of <jats:italic>Plasmodium<\/jats:italic> diagnosis in health facilities. However, the results of this study imply that capacity training for the identification of <jats:italic>Plasmodium<\/jats:italic> species in health facilities is warranted.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1243642","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T04:49:00Z","timestamp":1695962940000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of performance for malaria diagnosis in health facilities by five provincial reference laboratories of 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