Experiences in establishing a PEPFAR-supported laboratory quality system in Nigeria.
The need to accurately diagnose HIV-infected persons and monitor their immune status and sequelae from increased access to antiretroviral therapy dictated the establishment of a quality assurance (QA) system supported by dedicated personnel, financial resources, and a close monitoring system. Assessment of laboratories and personnel in Nigeria revealed the need for improved laboratory infrastructure and training, including on-site didactic and wet workshops and the institution of a tiered QA unit of laboratory regional officers, focal persons, and site monitors who provided guidance and continuous monitoring. Quarterly assessments and generated reports guided corrective actions. A sustainable quality laboratory system was developed for the first time in Nigeria with funding from the US President's Emergency Plan for AIDS Relief. With expansion from 7 to 34 comprehensive treatment sites, a tiered laboratory organizational structure with regional and site-based Nigerian quality control officers was developed. Measured improvements included reduction in deficiencies from 13% to 2%.
Abimiku
Alash'le G
AG
Institute of Human Virology, University of Maryland School of Medicine, 725 W Lombard St, N449, Baltimore, MD 21201, USA.
Croxton
Talishiea
T
Akintunde
Ezekiel
E
Okelade
Bimpe
B
Jugu
Joseph
J
Peters
Sam
S
Dakum
Patrick
P
Blattner
William
W
Constantine
Niel
N
D019411:Clinical Laboratory Techniques / Q000592:standards; D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007391:International Cooperation; D007753:Laboratories / Q000592:standards*; D008297:Male; D017056:Medical Laboratory Personnel / Q000193:education; D009549:Nigeria; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D011786:Quality Control