ASD - PAKISTAN

TB microscopy external quality assurance in Pakistan

The WHO strategy for tuberculosis control (DOTS) relies on a network of laboratories that can diagnose TB through microscopy of patient sputum. It is WHO policy to implement external quality assurance (EQA) so as to ensure reliable diagnosis, identify more cases and monitor cure rates.

In Pakistan, EQA for sputum testing in diagnostic centers is a priority challenge being faced by the TB programme and the Association for Social Development, through a COMDIS project, developed and evaluated context-sensitive operational guidelines and tools relating to sputum testing in diagnostic centers. These are based on the WHO EQA guidelines, but with more operational detail, and linking EQA with routine laboratory supervision.

The study shows that district health offices and provincial reference laboratories can come together to achieve effective planning and implementation of quality control activities. In the study districts, the use of these guidelines, tools and training materials successfully established a system for quality control and improved the quality of microscopy.