JULIANA HAGEMBE, MPH, MSC

INNOVATIVE TOOLS FOR IMPROVING LABORATORY

CAPACITY & QUALITY IN SUB-SAHARAN AFRICA

• Laboratories play important role in fighting diseases

• HIV• HIV test

• Viral Load

• CD4 cell count

• Kidney Function text (Toxicity)

• Drug resistance assay (Monitor)

INTRODUCTION

• Quality assurance crucial!

• Lab results usefulness

• Timely

• Reliable

• Reproducible

Rural labs - Limited National Quality assessment participation

246 LocalPartner

TreatmentFacilities

+ 184 satellite

sites

LABS SUPPORTED BY IHV(UMSOM)

• PROBLEM• 60% in Rural Areas

• Cannot be linked to central services

• Persisting Issues related to reliability of diagnostic services

• SOLUTION• Laboratory Quality improvement tools ( LQITS)

• Targeted Mentoring approach

• Strengthen the pre-analytical, analytical and post analytical stages of total diagnostic process

• LQIT: 100 close ended question, 12 Sections Staff Safety Equipment/Supplies Reagents Quality control Maintenance Inventory Sample collection Results reporting Sample transport SOP/Documentation Sample processing

LQIT

EQUIPMENT/SAFETY

04/12/2023 Slide 7

WASTE MANAGEMENT

04/12/2023 Slide 8

STAFF/MAINTANCE/QC/DOCUMENTATION

LQIT• Initial LQIT scores used as

baseline

• Labs visited on a regular basis and graded• Quality of services provided

• Personal skill/knowledge level

• Tailored site-specific interventions during TA visits

• Improvements in the quality of tests for diagnostics monitored

• Major gap in the primary laboratories by LQIT

• Better planning of trainings

• Continual development/ maintenance of quality

• Step closer to meeting international accreditation (e.g. WHO-AFRO)

RESULTS

MALARIA LQIT SCORES

I: Sta

ff

II: Sa

fety

III: E

quipment/supplie

s

IV: S

lides p

reparation

V: Stai

ning

VI: Micr

oscope

VII: Main

tenance

VIII: Sl

ides read

ing and re

por...

IX: S

tandard

Operati

ng Proce

...

X: Docu

mentation

XI: Quali

ty Contro

ls

XII: Inve

ntory

TOTA

L SCORE (

100)0

50

100Nigeria Rwanda Uganda Tanzania Zambia Kenya

Bunda Tarime Muheza SeKou Toure

0

50

100

Visit 1Visit 2Visit 3Visit 4

CD4 LQIT SCORES (TANZANIA SITE 2011-2012)

• Routine use of LQIT valid approach for ingraining CQI activities

• Maintain high quality of diagnostic services at primary level facilities

• Funding to ensure regular visits to sites• Competing priorities

CHALLENGES

SUMMARY