Learning Unit 12. Supervisory aspects of malaria microscopy

Learning objectives By the end of this Unit you should: · understand why supervision of your work is necessary · be aware that supervision can be carried out in a number of ways · understand what you must do in order to help your supervisor in his or her job.

The need for supervision

Supervision is necessary for a number of reasons:

· It confirms that you are doing your job as you have been trained to do it.

· It enables you to make minor but necessary corrections to your work.

· It should indicate whether you need retraining or are suitable for further and more advanced training.

· It provides a good opportunity for you to discuss with your supervisor any difficulties you may be having in your work.

Types of supervision

There are two basic types of supervision - direct and indirect.

Direct supervision

In direct supervision your supervisor is able to be in constant touch with you over a period of time. That period may be a single day, if your supervisor is visiting your place of work, or longer. The supervisor is able to see what you do in your job and how you do it. You have the opportunity to discuss important aspects of your work, and this is helpful to both of you.

Indirect supervision

In indirect supervision the supervisor can judge how well you are working only from the records that you submit regularly. However, he or she also needs to see how you are dealing with your slides, what the quality of your staining is, and how accurately slides are being examined, and may also want to know whether or not your microscope and other equipment are in good working order.

To assess the quality of staining and blood film examination, the supervisor will need to re-examine, or cross-check, a number of your slides. Usually, you will send all the positive slides to your supervisor so that the species and density of parasites can be confirmed and to ensure that you are not mistaking artefacts for parasites. You will also send 10% of the slides that you have found to be negative, and these will be re-examined to make sure that you are not overlooking the low-density positives.

Selecting 10% of the negative slides is not difficult. The most common system is for your supervisor to indicate selection by the last digit of the slide number. For example: you might be instructed to select all slides whose number ends with 5. Provided that you have consecutively numbered your slides for the month, this is an easy task. (If any of the slides whose number ends with 5 happens to be positive, simply select the slide next to it, say the one ending in 6.) The selected slides will then be sent to your supervisor, with the forms and the short report that you may have written.

It is your supervisor’s task to examine your slides as soon as possible after receiving them. If there is any disagreement about your diagnoses or parasite counts, this should be discussed with you at the earliest opportunity. Preferably, you should see the slide or slides in question, so that you can be made aware of where you went wrong.

Referring to the Learning Units, diagrams and colour plates in this Guide will continue to help you in your daily work. Remember that you have a very important job to do and that you must try to do it as well and as accurately as you can. Even though your supervisor may be far away, he or she should always be informed of any problems you may encounter: it is the supervisor’s job to help you when difficulties arise.

WHO publications of related interest

	Price*
	(Sw.fr.)
Entomological field techniques for malaria control Part I: Learner’s guide. 1992 (77 pages) Part II: Tutor’s guide. 1992 (54 pages)	15.- (10.50) 12.- (8.40)
Management of severe and complicated malaria A practical handbook. H.M. Gilles 1991 (62 pages)	9.- (6.30)
A global strategy for malaria control 1993 (40 pages)	11.- (7.70)
Implementation of the Global Malaria Control Strategy Report of a WHO Study Group on the Implementation of the Global Plan of Action for Malaria Control 1993-2000 WHO Technical Report Series, No. 839. 1993 (62 pages)	10.- (7.-)
The biology of malaria parasites Report of a WHO Scientific Group WHO Technical Report Series, No. 743,1987 (229 pages)	32.- (22.40)
Bench aids for the diagnosis of malaria 1988 (8 plates)	15.- (10.50)
WHO Expert Committee on Malaria Eighteenth report WHO Technical Report Series/No. 735.1986 (104 pages)	14.- (9.80)
Malaria control as part of primary health care Report of a WHO Study Group WHO Technical Report Series/No. 712. 1984 (73 pages)	8.- (5.60)
Vector control in primary health care Report of a WHO Scientific Group WHO Technical Report Series/No. 755.1987 (61 pages)	9.- (6.30)
Practical chemotherapy of malaria Report of a WHO Scientific Group WHO Technical Report Series/No. 805,1991 (141 pages)	16.- (11.20)
The clinical management of acute malaria, 2nd ed. WHO Regional Publications/South-East Asia Series, No. 9. 1986 (xii + 106 pages)	7.- (4.90)
Educational handbook for health personnel, 6th ed. WHO Offset Publication, No. 35. Revised and updated 1998 (389 pages)	50.- (35.-)

^* Prices in parentheses apply in developing countries.

Further information on these and other World Health Organization publications can be obtained from Distribution and Sales, World Health Organization, 1211 Geneva 27, Switzerland.