Boeras Debrah I, Peeling Rosanna W, Onyebujoh Philip, Yahaya Ali A, Gumede-Moeletsi Hieronyma N, Ndihokubwayo Jean B
London School of Hygiene and Tropical Medicine, London, United Kingdom.
World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo.
Afr J Lab Med. 2016 Oct 17;5(2):560. doi: 10.4102/ajlm.v5i2.560. eCollection 2016.
External Quality Assessment (EQA) surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO) revealed the need for the strengthening of public health microbiology laboratories, particularly for testing of epidemic-prone diseases in the African Region. These surveys revealed common issues such as supply chain management, skilled personnel, logistical support and overall lack of quality standards. For sustainable improvements to health systems as well as global health security, deficiencies identified need to be actively corrected through robust quality assurance programmes and implementation of laboratory quality management systems. Given all the pathogens of public health importance, an external quality assessment programme with a focus on vaccine-preventable diseases and emerging and re-emerging dangerous pathogens is important, and should not be stand-alone, but integrated within laboratory networks as seen in polio, measles, yellow fever and rubella. In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Prevention, the London School of Hygiene & Tropical Medicine and partners in a series of consultations with countries and national and regional EQA providers for the development of quality assurance models to support HIV point-of-care testing and monitoring. These consultations revealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forth its experience in implementing quality standards for health programmes, and also opened discussions on how lessons learned through such established programmes can be utilised to supporting and strengthening the introduction of early infant diagnosis of HIV and viral load point-of-care testing. An optimised external quality assessment programme will impact the ability of countries to meet core capacities, providing improved quality management systems, improving the confidence of diagnostic network services in Africa, and including capacities to detect events of international public health importance.
世界卫生组织非洲区域办事处（WHO AFRO）开展的外部质量评估（EQA）调查显示，有必要加强公共卫生微生物实验室，特别是在非洲区域对易流行疾病进行检测的实验室。这些调查揭示了一些常见问题，如供应链管理、技术人员、后勤支持以及整体缺乏质量标准等。为了实现卫生系统的可持续改善以及全球卫生安全，需要通过强有力的质量保证计划和实验室质量管理体系的实施，积极纠正所发现的缺陷。鉴于所有具有公共卫生重要性的病原体，一个侧重于疫苗可预防疾病以及新出现和重新出现的危险病原体的外部质量评估计划很重要，而且不应孤立存在，而应像在脊髓灰质炎、麻疹、黄热病和风疹方面那样，纳入实验室网络。2015年，WHO AFRO与美国疾病控制与预防中心、伦敦卫生与热带医学院以及合作伙伴一道，与各国以及国家和区域EQA提供者进行了一系列磋商，以制定质量保证模型，支持艾滋病毒即时检测和监测。这些磋商揭示了与WHO AFRO调查中类似的挑战。WHO AFRO介绍了其在实施卫生计划质量标准方面的经验，还开启了关于如何利用通过此类既定计划吸取的经验教训来支持和加强引入艾滋病毒早期婴儿诊断及病毒载量即时检测的讨论。一个经过优化的外部质量评估计划将影响各国达到核心能力的能力，提供改进的质量管理体系，增强非洲诊断网络服务的信心，并包括检测具有国际公共卫生重要性事件的能力。
