Abstract
Participation in an EQA program is critical to the quality assurance process. Reliable and precise CD4 T-cells enumeration are essential to improve the clinical management of patients by evaluating the disease progression and by monitoring the effectiveness of ART in HIV-patients. The CIRCB, CD4 reference laboratory, in collaboration with the Canadian QASI-program, recruited sites, distributed and analyzed CD4-panels in 61 sites across Cameroon. A trend and performance analysis in the pre-analytical, analytical and post-analytical phases was performed. Continuous training and corrective actions carried out from 2014 to 2018 increased the number of participating sites from 15 to 61 sites, the number of unacceptable results decreased from 50 to 10%. Specific challenges included errors in pre analytic (17.5%), analytic (77.0%) and post-analytic (5.5%) phases. This EQA requires the application of good laboratory practices, fluidic communication between all the stakeholders, continuous training, application of specific on-site corrective measures, and timely equipment maintenance in order to avoid repetitive errors and to increase laboratory performance. It could be extended to other HIV-1 testing like viral load and EID point-of-care. Partnership with QASI serve as a model for implementation of a successful EQA model for resource limited countries wanting to implement EQA for HIV testing and monitoring in alignment with 90–90–90 targets.
Highlights
Abbreviations AFREQAS African Regional External Quality Assessment Scheme ART Anti-retroviral therapy CIRCB Centre International de Référence Chantal BIYA pour la recherché sur la prise en charge du VIH/SIDA early infant diagnosis (EID) Early infant diagnosis external quality assurance (EQA) External quality assessment HIV Human Immunodeficiency Virus POC Point of care QASI Quality Assessment and Standardization of Indicators relevant to HIV/AIDS UKNEQAS United Kingdom National External Quality Assessment Scheme UNAIDS The Joint United Nations Programme on HIV/AIDS viral load (VL) Viral load
More than 38.0 million people are infected with Human Immunodeficiency Virus (HIV) and approximately 540,000 people in Cameroon are living with this infection at a prevalence of 3.6% in 2 0181
CD4 + T-cell lymphocytes are a primary target for HIV infection and these cells are depleted throughout the course of the disease
Summary
Abbreviations AFREQAS African Regional External Quality Assessment Scheme ART Anti-retroviral therapy CIRCB Centre International de Référence Chantal BIYA pour la recherché sur la prise en charge du VIH/SIDA EID Early infant diagnosis EQA External quality assessment HIV Human Immunodeficiency Virus POC Point of care QASI Quality Assessment and Standardization of Indicators relevant to HIV/AIDS UKNEQAS United Kingdom National External Quality Assessment Scheme UNAIDS The Joint United Nations Programme on HIV/AIDS VL Viral load. In 2014, UNAIDS established the 90:90:90 goals for HIV testing, accessible therapy, and viral suppression by 20202 These targets were followed by new guidelines from the WHO in 2016, which recommend VL as the preferred approach to ART monitoring compared to clinical or immunological criteria[3]. Various EQA programs for CD4 enumeration exist internationally and include QASI-LI in Canada, UKNEQAS in England, and AFREQAS in South A frica[19,20,21,22], among others, both commercial and non-commercial. Many of these EQA programs are cost prohibitive to resource-limited countries already committing their resources to procuring the testing kits. Together with QASI, the Chantal BIYA International Reference Center for Research on Prevention and Management of HIV AIDS (CIRCB) initiated a collaborative working relationship to develop a strong CD4 quality assessment program within the CIRCB to oversee CD4 testing throughout Cameroon
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
