Ensuring accurate testing for human immunodeficiency virus in Myanmar.

Area of Science:

• Public Health
• Laboratory Medicine
• Infectious Disease Control

Background:

• Prior to 2005, Myanmar lacked consistent monitoring and technical support for rapid diagnostic human immunodeficiency virus (HIV) testing in hospital laboratories.
• This absence of quality control impacted the reliability of HIV diagnostic services nationwide.

Purpose of the Study:

• To implement and assess a national external quality assessment (EQA) scheme for HIV testing in Myanmar.
• To improve the quality and consistency of HIV diagnostic services across public and non-governmental organization (NGO) laboratories.

Main Methods:

• Introduction of a national EQA scheme by the national reference laboratory.
• Training of laboratory technicians on HIV testing and EQA procedures.
• Implementation of biannual proficiency panel testing and on-site assessments.
• Development and dissemination of national HIV testing guidelines.

Main Results:

• The EQA scheme expanded from 65 laboratories in 2005 to 347 laboratories by 2012.
• Laboratory response rates consistently exceeded 90% during the scheme's expansion.
• The proportion of laboratories reporting aberrant results decreased from 9.2% in 2005 to 5.4% in 2012, indicating improved testing accuracy.

Conclusions:

• National guidelines and a dedicated reference laboratory are essential for effective HIV testing quality assurance.
• On-site assessments provide critical insights into testing errors and facilitate national knowledge sharing.
• Proficiency testing is vital for maintaining laboratory technicians' skills and ensuring accurate detection of HIV-positive samples.