External Quality Assessment of National Public Health Laboratories in Africa, 2002-2009/ Evaluation Externe De la Qualite Des Laboratoires De Sante Publique Nationaux En Afrique, 2002-2009/ Evaluacion Externa De la Calidad De Los Laboratorios Nacionales De la Sanidad Publica En Africa, 2002-2009
Year: 2012
Type: article
Abstract: Introduction In Africa, communicable diseases constitute a very important public health problem and outbreaks pose serious threats to health. (1) These diseases exert enormous influence on the economy and society and should be targeted through aggressive disease prevention, control and surveillance activities. However, successful performance of these activities requires reliable epidemiologic data and generating such data is one of the roles of national public health laboratories. (2) This awareness led the Regional Committee for Africa of the World Health Organization (WHO) to recommend strengthening the ability of national public health laboratories to accurately, reliably and promptly confirm epidemics in an effort to improve the public health response and enhance national and global health security. This was the intention behind its adoption of the strategy for integrated disease surveillance and response in 1998 (3) and of Resolution AFR/RC58/R2 in 2008. (3-5) The integrated disease surveillance and response technical guidelines recommend the use of standard laboratory diagnostic methods for priority diseases in the WHO African Region. (6) In many African countries, reliable confirmation of suspected infectious diseases is hampered by a lack of standardized diagnostic methods and by a shortage of funds, staff and laboratory supplies for national public health laboratories, despite the critical role played by these laboratories as part of a functional infrastructure for disease surveillance. (7) Development and maintenance of high-quality national public health laboratory services require financial and managerial commitment to provide qualified staff, training, equipment, consumables, reagents and physical facilities. Periodic quality assessment of performance is also essential because it can help ensure the reliability of findings and is an important component of laboratory accreditation, towards which national public health laboratories should, ideally, strive. In July 2002, WHO launched an external quality assessment programme (EQAP) to test the proficiency of microbiological testing for epidemic-prone diseases by laboratories in the African Region. (8) The EQAP was extended to laboratories in three African Member States in the Region of the Eastern Mediterranean during 2005. The National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service of South Africa, provided technical coordination following an agreement with the co-funders, the WHO Regional Office for Africa and the WHO office in Lyon, France. (8-10) Accordingly, the NICD undertook to provide specimens for laboratory identification of selected agents of bacterial enteric diseases, bacterial meningitis and plague; to advise WHO about the needs of participating laboratories, to correct deficiencies and maintain proficiency; and to further extend the EQAP to include general bacteriological analyses and tuberculosis and malaria microscopy. (11) This article reviews findings from microbiology EQAP surveys conducted by WHO and NICD in Africa during 2002-2009. Methods Participating laboratories The WHO Regional Office for Africa invited national public health laboratories (nominated by their ministries of health) and/or the main hospital or research laboratories functioning as such, as well as laboratories in the Paediatric Bacterial Meningitis Surveillance Network, (12) to participate in the bacterial enteric diseases and bacterial meningitis components of the EQAP (Table 1, available at: http://www.who.int/ bulwletin/volumes/90/11-091876). Some laboratories were both national public health laboratories and in the Paediatric Bacterial Meningitis Surveillance Network. (12) Certain laboratories were also recruited to participate in the plague, tuberculosis and malaria components of the EQAP because of their expertise in these areas. Coordination and technical guidance The NICD Technical Implementation Group, together with representatives from WHO's African Regional Office and the WHO's Lyon Office, coordinated the EQAP. …
Language: Spanish
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2615159999
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