Evaluation of an External Quality Assessment Program for HIV Testing in Haiti, 2006–2011

Abstract

Objectives To evaluate an external quality assessment (EQA) program for human immunodeficiency virus (HIV) rapid diagnostics testing by the Haitian National Public Health Laboratory (French acronym: LNSP). Acceptable performance was defined as any proficiency testing (PT) score more than 80%. Methods The PT database was reviewed and analyzed to assess the testing performance of the participating laboratories and the impact of the program over time. A total of 242 laboratories participated in the EQA program from 2006 through 2011; participation increased from 70 laboratories in 2006 to 159 in 2011. Results In 2006, 49 (70%) laboratories had a PT score of 80% or above; by 2011, 145 (97.5%) laboratories were proficient (P < .05). Conclusions The EQA program for HIV testing ensures quality of testing and allowed the LNSP to document improvements in the quality of HIV rapid testing over time.

Evaluation of an External Quality Assessment Program for HIV Testing in Tigray North Ethiopia 2016

“…Because our study participants included all testing points and they performed HIV testing using HIV rapid test but their study participants' only laboratory professionals and they used HIV rapid test and ELISA to perform HIV rapid testing. Our findings demonstrated that 82.8% of testing points score 80 and above this lower than study conducted by Jean Louis and his colleagues which was 97.5% [14]. …”

To err is human, to correct is public health: a systematic review examining poor quality testing and misdiagnosis of HIV status

“…Most studies were carried out in Africa ( n  = 48) [5,7,10–14,16,22–25,29,30,32–34,36,37,39,41,43,44,46,47,49,51,52,54–59,61–65,67–72,74,75], followed by in the Americas ( n  = 7) [28,31,42,50,53,60,66], Asia ( n  = 4) [8,35,45,73] and Europe ( n  = 1) [48]. There were also four multi-country/regional studies [26,27,38,40].…”

“…Thirty-seven studies reported using a suboptimal testing strategy that differed from the WHO recommendations [5,8,11–14,16,22–30,32–34,36–39,42–44,49,51,53,59,62,64–66,68,72,75]. Suboptimal testing strategies included using a highly specific first-line test and highly sensitive second-line test [14,33,39,55], using a single RDT for HIV-positive diagnoses [11,66,72], using a high prevalence testing strategy in a low prevalence setting [16,49], using a parallel testing algorithms and a tiebreaker testing strategy (where a third assay is used to resolve discrepant test results and rule in HIV infection) [5,12,13,16,24,25,27–30,32,34,36,37,68].…”

“…Errors identified included users having difficulty with specimen collection [14,28,68], performing RDTs [31,73], interpreting test results [10,24,27,30,32,40,42,48,62,65,66,74], reading test results too early [7] and not using the correct reagents/buffer [7]. …”

“…User errors, incorrectly performing the test procedure or incorrectly interpreting results, defined as human errors, were reported in 25 studies [7,8,11,14,[26][27][28]31,33,34,37,40,42,46,52,54,57,60,[65][66][67][68]70,72,73]. Errors identified included users having difficulty with specimen collection [14,28,68], performing RDTs [31,73], interpreting test results [10,24,27,30,32,40,42,48,62,65,66,74], reading test results too early [7] and not using the correct reagents/buffer [7].…”