External Quality Assurance Scheme in a National Reference Laboratory for HIV Testing in South India

Sushi, Kamala Mary; Gopal, Thatchinamoorthy; Jacob, Saramma Mini; Arumugam, Ganesan; Durairaj, Anitha

doi:10.4236/wja.2012.23028

Cited by 3 publications

(1 citation statement)

References 4 publications

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“…Similar results were obtained in different countries [28,29]. For example, Indian EQAS system scheme also evaluated reference laboratories performance of North and South Indian regions on HIV-testing parameters and reported satisfactory results in general [30,31].…”

Section: Discussionsupporting

confidence: 65%

Assessment of External Quality Assurance Scheme Participation Level, on Salmonella and Shigella Species

Derra¹,

Mariam²,

Biza³

et al. 2019

Open Microbiol. J.

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Background: External Quality Assurance Scheme (EQAS) is the system which allows every laboratory to compare its overall performance with other internal and external existing laboratories, working in similar disciplines. Significant improvements were reported in different laboratories and countries after attending one or more of such programs. The project objective was to assess EQAS participation level in Salmonella and Shigella species that had been processed for six years under WHO-AFRO GSS EQAS program. Methodology: Samples received for Salmonella and Shigella species, as well as Campylobacter and other unknown enteric pathogens identification were directly inoculated to the suitable and selective media according to the type of organisms. Serogroups were reported using terms according to Kauffmann-White-Le Minor procedures. For antimicrobial susceptibility testing, drug diffusion method and CLSI interpretation guideline was used. Results: From the overall participation (2008-2013), serogrouping results were correctly reported as 62/ 71 (87%). None of the deviations was recorded for Shigella species. Participation for Campylobacter species was only twice per six years, in 2009 and 2010; the results of agreement with the expected values were ½ (50%) and 2/2 (100%) respectively. In line with this, the antimicrobial susceptibility participation was correctly reported as 320/356 (89.9%). Conclusion: Even though everyone has gained knowledge and awareness about the benefits of EQAS by default, its acceptance and implementation in developing countries are less communicated and exercised. The final recommendation will be that all higher officials and policymakers in the field have to give attention to it and allocate adequate budget on a continuous basis.

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Section: Discussionsupporting

confidence: 65%

Assessment of External Quality Assurance Scheme Participation Level, on Salmonella and Shigella Species

Derra¹,

Mariam²,

Biza³

et al. 2019

Open Microbiol. J.

View full text Add to dashboard Cite

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Accuracy in HIV Rapid Testing among Laboratory and Non-laboratory Personnel in Zambia: Observations from the National HIV Proficiency Testing System

et al. 2016

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BackgroundDespite rapid task-shifting and scale-up of HIV testing services in high HIV prevalence countries, studies evaluating accuracy remain limited. This study aimed to assess overall accuracy level and factors associated with accuracy in HIV rapid testing in Zambia.MethodsAccuracy was investigated among rural and urban HIV testing sites participating in two annual national HIV proficiency testing (PT) exercises conducted in 2009 (n = 282 sites) and 2010 (n = 488 sites). Testers included lay counselors, nurses, laboratory personnel and others. PT panels of five dry tube specimens (DTS) were issued to testing sites by the national reference laboratory (NRL). Site accuracy level was assessed by comparison of reported results to the expected results. Non-parametric rank tests and multiple linear regression models were used to assess variation in accuracy between PT cycles and between tester groups, and to examine factors associated with accuracy respectively.ResultsOverall accuracy level was 93.1% (95% CI: 91.2–94.9) in 2009 and 96.9% (95% CI: 96.1–97.8) in 2010. Differences in accuracy were seen between the tester groups in 2009 with laboratory personnel being more accurate than non-laboratory personnel, while in 2010 no differences were seen. In both PT exercises, lay counselors and nurses had more difficulties interpreting results, with more occurrences of false-negative, false-positive and indeterminate results. Having received the standard HIV rapid testing training and adherence to the national HIV testing algorithm were positively associated with accuracy.ConclusionThe study showed an improvement in tester group and overall accuracy from the first PT exercise to the next. Average number of incorrect test results per 1000 tests performed was reduced from 69 to 31. Further improvement is needed, however, and the national HIV proficiency testing system seems to be an important tool in this regard, which should be continued and needs to be urgently strengthened.

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Ensuring accurate testing for human immunodeficiency virus in Myanmar

Kyaw

Nozaki

Wada

et al. 2014

Bull. World Health Organ.

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ProblemUntil 2005, the quality of rapid diagnostic human immunodeficiency virus (HIV) testing was not monitored and no regular technical support was provided to hospital laboratories in Myanmar.ApproachThe national reference laboratory introduced a national external quality assessment scheme. The scheme involved (i) training laboratory technicians in HIV testing and in the requirements of the quality assessment system; (ii) implementing a biannual proficiency panel testing programme; (iii) on-site assessments of poorly-performing laboratories to improve testing procedures; and (iv) development of national guidelines.Local settingIn 2011, a total of 422 public hospitals in Myanmar had laboratories providing HIV tests. In addition, private laboratories supported by nongovernmental organizations (NGOs) conducted HIV testing.Relevant changesThe scheme was started in 65 public laboratories in 2005. In 2012, it had expanded nationwide to 347 laboratories, including 33 NGO laboratories. During the expansion of the scheme, laboratory response rates were greater than 90% and the proportion of laboratories reporting at least one aberrant result improved from 9.2% (6/65) in 2005 to 5.4% (17/316) in 2012.Lessons learntNational testing guidelines and a reference laboratory are needed to successfully implement quality assurance of HIV testing services. On-site assessments are crucial for all participating laboratories and the only source for insight on the causes of aberrant results; lessons that the reference laboratory can share nationally. Proficiency testing helps laboratory technicians to maintain HIV testing skills by ensuring that they regularly encountered HIV-positive samples.

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External Quality Assurance Scheme in a National Reference Laboratory for HIV Testing in South India

Cited by 3 publications

References 4 publications

Assessment of External Quality Assurance Scheme Participation Level, on Salmonella and Shigella Species

Assessment of External Quality Assurance Scheme Participation Level, on Salmonella and Shigella Species

Accuracy in HIV Rapid Testing among Laboratory and Non-laboratory Personnel in Zambia: Observations from the National HIV Proficiency Testing System

Ensuring accurate testing for human immunodeficiency virus in Myanmar

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