Vietnam: Laboratory Quality under the Microscope in Vietnam (October 2009)

Through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the U.S. Government has helped to dramatically scale up counseling and testing in Vietnam by supporting free and confidential services at more than 130 sites.

Vietnam has long suffered from a shortage of trained personnel, aging equipment and inconsistent quality standards, which have hampered the ability to produce accurate HIV diagnostic test results.

In 2006, the U.S. Centers for Disease Control and Prevention began working with the Vietnamese National Institute of Hygiene and Epidemiology (NIHE) to develop an external quality assessment program that would identify laboratories with a high rate of testing errors.

The U.S. Department of Defense, working with its counterpart in Vietnam, supported similar training at the Military Institute of Hygiene and Epidemiology.

Through these programs, staff from both institutes were sent to Thai government testing facilities in Bangkok for training. They returned with panels of serum that allowed them to conduct an assessment of HIV testing in Vietnamese laboratories. These serum panels were sent to more than 100 provincial and regional laboratories to be tested and the results were compared among all laboratory participants from the program.

While laboratories use different techniques and test kits, if a sample is positive, it should test positive independent of the methods used.

The initial results identified several laboratories with problems. To address problematic areas, NIHE developed its own external quality assessment plan and response. Laboratories that performed poorly were offered training to improve their skills. As a result, over the past three years, participating laboratories demonstrated vast improvements, a remarkable turnaround in such a short period of time.

PEPFAR will now look for ways to expand this successful program to other laboratories, including those at military sites that offer HIV testing.

"Although this program is newly established," says Dr. Nguyen Thanh Long, Director of the Vietnam Administration for HIV/AIDS Control, "it has gained remarkable results and has been a significant component in assuring the quality of HIV testing services in Vietnam."

Dr. Long believes that this model should be expanded and applied to all clinical tests, not just those related to HIV, so that more patients can benefit from quality testing.

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