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The present External Quality Assessment (EQA) assessed microscopy of blood parasites among diagnostic laboratories in the Democratic Republic of the Congo. The EQA addressed 445 participants in 10/11 provinces (October 2013–April 2014). Participants were sent a panel of five slides and asked to return a routinely stained slide which was assessed for quality of preparation and staining. Response rate was 89.9% (400/445). For slide 1 (no parasites), 30.6% participants reported malaria, mostly  Plasmodium falciparum . Only 11.0% participants reported slide 2 ( Plasmodium malariae ) correctly, 71.0% reported “malaria” or “ Plasmodium falciparum ” (considered acceptable). Slide 3 contained  Plasmodium falciparum  (109/μl) and  Trypanosoma brucei brucei  trypomastigotes: they were each reported by 32.5% and 16.5% participants respectively, 6.0% reported both. Slide 4 ( Trypanosoma ) was recognised by 44.9% participants. Slide 5 ( Plasmodium ovale ) was correctly reported by 6.2% participants, another 68.8% replied “malaria” or “ Plasmodium falciparum ” (considered acceptable). Only 13.6% of routine slides returned were correctly prepared and stained. The proportion of correct/acceptable scores for at least 4/5 slides was higher among EQA-experienced participants compared to first time participants (40.9% versus 22.4%,  p  = 0.001) and higher among those being trained < 2 years ago compared to those who were not (42.9% versus 26.3%,  p  = 0.01). Among diagnostic laboratories in Democratic Republic of the Congo, performance of blood parasite microscopy including non- falciparum  species and  Trypanosoma  was poor. Recent training and previous EQA participation were associated with a better performance.

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Performance of Microscopy for the Diagnosis of Malaria and Human African Trypanosomiasis by Diagnostic Laboratories in the Democratic Republic of the Congo: Results of a Nation-Wide External Quality Assessment