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Background  In China, the prevalence of malaria has reduced dramatically due to the elimination programme. The continued success of the programme will depend upon the accurate diagnosis of the disease in the laboratory. The basic requirements for this are a reliable malaria diagnosis laboratory network and quality management system to support case verification and source tracking.    Methods  The baseline information of provincial malaria laboratories in the China malaria diagnosis reference laboratory network was collected and analysed, and a quality-assurance activity was carried out to assess their accuracies in malaria diagnosis by microscopy using WHO standards and PCR.    Results  By the end of 2013, nineteen of 24 provincial laboratories have been included in the network. In the study, a total of 168 staff were registered and there was no bias in their age, gender, education level, and position. Generally  Plasmodium  species were identified with great accuracy by microscopy and PCR. However,  Plasmodium ovale  was likely to be misdiagnosed as  Plasmodium vivax  by microscopy.    Conclusions  China has established a laboratory network for primary malaria diagnosis which will cover a larger area. Currently,  Plasmodium  species can be identified fairly accurately by microscopy and PCR. However, laboratory staff need additional trainings on accurate identification of  P. ovale  microscopically and good performance of PCR operations.

Establishing a China malaria diagnosis reference laboratory network for malaria elimination