External Quality Assessment (EQA) of Laboratory Tuberculosis Diagnosis in Lagos State, Nigeria: A Three-Year Review

Abstract

The low detection of tuberculosis cases is a big problem in Nigeria. The rate of accurate diagnosis while ensuring the quality of TB treatment monitoring tool – AFB, with a 90% Pass grade system among the testing laboratories requires to be monitored. Therefore, this study evaluated the external quality assessment (EQA) of TB diagnosis to satisfy laboratory quality requirements in Lagos, Nigeria. This study was conducted using data from 132 laboratories in Lagos, examining 3years retrospective EQA reports from 2019 to 2021. A structured data abstraction chart was employed to extract EQA data from the STBLCP database, while a trained supervisor checked for completeness, clarity, and consistency of data. IBM-SPSS version 28.0 was used for data analysis. The external assessment report showed an improved TB Laboratory diagnostic performance in the 2nd quarter of 2019 and 2020, but a decline was noticed in the 3rd and the 4th quarters. There was an increase in the overall laboratory performance from 94.4% in 2019 to 96.1% in 2020. A significant proportion (79.2%) of the slides assessed in 2019 passed external assessment tests (had a concordant score of 90 and above). However, the performance was significantly better in 2020 (84.2%) and 2021 (88.2%). Laboratories should be upgraded to a world-standard level, and staff should be well-trained, with periodic competency assessments to make reliable diagnoses, while ensuring all testing laboratories are enrolled in EQA program for the measure of quality laboratory services and consistency in service delivery. Keywords: Assessment, Diagnosis, External, Laboratory, Tuberculosis, Quality.