External quality assessment (EQA) combined with on-site technical evaluation for capacity building in clinical microbiology laboratories in Pakistan

Authors

Noureen Saeed, Aga Khan UniversityFollow
Muhammad Zeeshan, Aga Khan University
Dania Khalid Saeed, Aga Khan UniversityFollow
Joveria Farooqi, Aga Khan UniversityFollow
Sadia Shakoor, Aga Khan UniversityFollow
Imran Ahmed, Aga Khan UniversityFollow
Kauser Jabeen, Aga Khan UniversityFollow
Rumina Hasan, Aga Khan UniversityFollow
Jason Rao, Health Security,USA

Document Type

Article

Department

Pathology and Laboratory Medicine

Abstract

Objectives
Implementation of standard laboratory practices towards accurate antimicrobial susceptibility testing (AST) is challenging in resource-constrained settings. Efforts to improve AST are required to address knowledge and practice gaps in such settings. In this study, we aimed to address these gaps through external quality assurance surveys and mentoring of laboratories in Pakistan.
Methods:
This prospective study (May 2017–September 2019) included 10 consenting laboratories. External quality assessment (EQA) was conducted quarterly and performance scored. Each EQA cycle was followed by an on-site technical visit during which AST methodology, quality procedures and laboratory safety were evaluated using a questionnaire developed for this study. Cumulative scores of performances in the EQA and in the technical evaluation were designated “Composite Laboratory Performance Score; CLPS”. During on-site visits, feedback provided was to each participating laboratory towards addressing gaps identified.
Results
Over the course of the study, our data show significant improvement in CLPS amongst the laboratories included. While improvement in the CLPS scores varied between laboratories, a linear regression model showed improvement within the cohort from 21.37 (May 2017) to 91.5 (September 2019); a significant overall increase of 70.13 points (p = 0.001).
Conclusion:Interventions to improve AMR surveillance include quality assured reporting of antimicrobial resistance. Our data show that in resource-limited settings EQA surveys and on-site evaluations followed by guidance contribute towards such improvement. We propose that this model would be a useful tool for laboratory strengthening in such settings.

AKU Student

no

Publication (Name of Journal)

Accreditation and Quality Assurance

Recommended Citation

Saeed, N., Zeeshan, M., Saeed, D. K., Farooqi, J., Shakoor, S., Ahmed, I., Jabeen, K., Hasan, R., Rao, J. (2025). External quality assessment (EQA) combined with on-site technical evaluation for capacity building in clinical microbiology laboratories in Pakistan. Accreditation and Quality Assurance, 27, 103-107.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_pathol_microbiol/1636