title: External quality assessment of dengue and chikungunya diagnostics in the Asia Pacific region, 2015.
abstract: OBJECTIVE
  To conduct an external quality assessment (EQA) of dengue and chikungunya diagnostics among national-level public health laboratories in the Asia Pacific region following the first round of EQA for dengue diagnostics in 2013.
  
  
  METHODS
  Twenty-four national-level public health laboratories performed routine diagnostic assays on a proficiency testing panel consisting of two modules. Module A contained serum samples spiked with cultured dengue virus (DENV) or chikungunya virus (CHIKV) for the detection of nucleic acid and DENV non-structural protein 1 (NS1) antigen. Module B contained human serum samples for the detection of anti-DENV antibodies.
  
  
  RESULTS
  Among 20 laboratories testing Module A, 17 (85%) correctly detected DENV RNA by reverse transcription polymerase chain reaction (RT-PCR), 18 (90%) correctly determined serotype and 19 (95%) correctly identified CHIKV by RT-PCR. Ten of 15 (66.7%) laboratories performing NS1 antigen assays obtained the correct results. In Module B, 18/23 (78.3%) and 20/20 (100%) of laboratories correctly detected anti-DENV IgM and IgG, respectively. Detection of acute/recent DENV infection by both molecular (RT-PCR) and serological methods (IgM) was available in 19/24 (79.2%) participating laboratories.
  
  
  CONCLUSIONS
  Accurate laboratory testing is a critical component of dengue and chikungunya surveillance and control. This second round of EQA reveals good proficiency in molecular and serological diagnostics of these diseases in the Asia Pacific region. Further comprehensive diagnostic testing, including testing for Zika virus, should comprise future iterations of the EQA.
authors: WHO Collaborating Centre for Reference and Research of Arbovirus and their Associated Vectors, Environmental Health Institute, National Environment Agency, Singapore.; Both authors contributed equally in the writing of this paper.
authors: Li Ting
authors: LT
authors: Soh
authors: Emerging Disease Surveillance and Response, Division of Health Security and Emergencies, World Health Organization Regional Office for the Western Pacific, Manila, Philippines.; Both authors contributed equally in the writing of this paper.
authors: Raynal C
authors: RC
authors: Squires
authors: WHO Collaborating Centre for Reference and Research of Arbovirus and their Associated Vectors, Environmental Health Institute, National Environment Agency, Singapore .
authors: Li Kiang
authors: LK
authors: Tan
authors: WHO Collaborating Centre for Reference and Research of Arbovirus and their Associated Vectors, Environmental Health Institute, National Environment Agency, Singapore .
authors: Kwoon Yong
authors: KY
authors: Pok
authors: WHO Collaborating Centre for Reference and Research of Arbovirus and their Associated Vectors, Environmental Health Institute, National Environment Agency, Singapore .
authors: HuiTing
authors: H
authors: Yang
authors: WHO Collaborating Centre for Reference and Research of Arbovirus and their Associated Vectors, Environmental Health Institute, National Environment Agency, Singapore .
authors: Christina
authors: C
authors: Liew
authors: Blood Safety and Laboratory Technology, Communicable Diseases Department, World Health Organization Regional Office for the South East-Asia, New Delhi, India .
authors: Aparna Singh
authors: AS
authors: Shah
authors: WHO Collaborating Centre for Reference and Research of Arbovirus and their Associated Vectors, Environmental Health Institute, National Environment Agency, Singapore .
authors: John
authors: J
authors: Aaskov
authors: WHO Collaborating Centre for Arbovirus Reference and Research (Dengue/Severe Dengue), Tropical Infectious Diseases Research and Education Centre, Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia .
authors: Sazaly
authors: S
authors: Abubakar
authors: WHO Collaborating Centre for Reference and Research on Tropical and Emerging Virus Diseases, Nagasaki University, Nagasaki, Japan .
authors: Futoshi
authors: F
authors: Hasabe
authors: WHO Collaborating Centre for Reference and Research of Arbovirus and their Associated Vectors, Environmental Health Institute, National Environment Agency, Singapore .
authors: Lee Ching
authors: LC
authors: Ng
authors: Emerging Disease Surveillance and Response, Division of Health Security and Emergencies, World Health Organization Regional Office for the Western Pacific, Manila, Philippines .
authors: Frank
authors: F
authors: Konings
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D001208:Asia / Q000453:epidemiology; D065632:Chikungunya Fever / Q000175:diagnosis* / Q000453:epidemiology; D002646:Chikungunya virus / Q000472:pathogenicity; D003715:Dengue / Q000175:diagnosis* / Q000453:epidemiology; D003716:Dengue Virus / Q000472:pathogenicity; D006801:Humans; D007753:Laboratories / Q000592:standards*; D010043:Outcome and Process Assessment, Health Care
chemical_list: D000914:Antibodies, Viral