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Table 1 Composition of the external quality assessment and scores for each photograph and multiple choice question (MCQ-scores)

From: SMS photograph-based external quality assessment of reading and interpretation of malaria rapid diagnostic tests in the Democratic Republic of the Congo

Photograph

Lines present

Possible options given for the multiple choice questions

Comments

C

Pan

P.f.

1. Invalid

2. Negative

3. Positive P.f.

4. Positive, P.f. mixed infection possible

5. Positive, P. non - falciparum

6. Positive, but species not known

A

+

-

F

6.9

29.1

54.8

3.0

1.7

4.5

Faint line (P.f.-HRP2) intensity read or interpreted as negative: 29.1%

B

+

-

-

5.2

90.0

2.6

0.4

0.7

1.0

Missing negative test: 10.0%

C

-

-

-

91.6

6.1

0.9

0.6

0.3

0.4

Missing invalid test (no control line, no test line): 8.4%

D

+

F

S

5.1

1.5

24.3

65.7

1.3

2.1

Faint line (pLDH) intensity read or interpreted as negative: 24.3%

Failure to distinguish presence of P.f.: 1.3% + 2.1% = 3.4%

E

+

-

-

6.5

87.6

2.1

1.8

1.0

1.0

Missing negative test: 12.4%

F

+

-

W

3.9

3.3

82.8

3.0

3.2

3.8

Failure to distinguish presence of P.f.: 3.2% + 3.8% = 7.0%

Incorrect reading as negative: 3.3%

G

+

F

-

6.4

7.2

6.1

4.7

70.7

4.9

Faint line (Pan-pLDH) intensity read as negative = 7.2%

Wrongly interpreted as P.f.: 6.1% + 4.7% = 10.8%

H

+

-

M

3.5

1.5

85.9

4.4

2.9

1.8

Medium line (P.f.-HRP2) intensity read or interpreted as negative = 1.5%

Failure to distinguish presence of P.f.: 2.9% + 1.8% = 4.7%

I

+

S

S

2.0

0.6

4.1

89.9

1.1

2.3

Failure to distinguish presence of P.f.: 1.1% + 2.3% = 3.4%

J

-

-

S

76.4

6.6

7.4

1.0

1.0

7.6

Missing invalid test; No control line, presence of test line: 23.6%

  1. The MCQ-scores present the percentage of health workers (n = 2344) who correctly replied. See Figure 1 for the picture of the photographs. Correct answers are displayed in bold.
  2. Abbreviations and symbols: C control line, Pan Plasmodium spp. (all four species), P.f. Plasmodium falciparum, negative (no line present), + positive (visible control line present), F faint positive line intensity compared to the control line, M medium positive line intensity compared to the control line, W weak positive line intensity compared to the control line, S strong positive line intensity compared to the control line.