Abstract
Malaria remains the leading cause of morbidity and mortality in Kasaï Oriental, particularly among children and pregnant women. Reliable biological diagnosis is critical to reduce medical errors and guide therapeutic decisions. Laboratories in Mbujimayi face persistent challenges related to organization, equipment, and staff training. This study aimed to assess diagnostic practices and identify priority areas for improvement. A descriptive cross-sectional study was conducted in 73 urban laboratories in Mbujimayi. Data were collected through direct observation, staff interviews, and document review. Inclusion criteria focused on laboratories performing microscopy (thick and thin smears). Variables analyzed included organizational structure, human resources, equipment availability, compliance with standards, and quality assurance practices. Most laboratories are private (71.2%) and operate with limited staff, often without registration, salary, or incentives. Training is insufficient: 81% of staff had never received malaria diagnostic training, and no technician was trained in the past two years. Rapid diagnostic tests (RDTs) dominate (90.4%), while microscopy is partially mastered, with species identification limited to 21.9%. Essential supplies are frequently lacking, and only 13.7% of laboratories participate in internal quality control. Organizational weaknesses are evident, with 82.2% lacking proper layout and 98.6% without non-conformity protocols. Findings highlight significant institutional and technical vulnerabilities compromising diagnostic reliability. Key challenges include lack of training (97.3%), reagents (75.3%), and equipment (69.9%). Strengthening staff capacity, establishing standardized quality assurance systems, and enhancing institutional support are essential to ensure accurate diagnoses and reduce malaria-related mortality.
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