The Togo national proficiency test pilot programme for basic clinical chemistry tests.

Many low-income countries lack national proficiency testing systems for clinical labs. Such systems help improve accuracy and performance. Prior research has shown that external quality assessment can reduce errors. However, no prior work had resolved how to implement these programs in resource-limited settings. The World Health Organization has set a target of 80% acceptable results. Togo's Ministry of Health recognized a gap in laboratory performance monitoring. No existing studies had evaluated Togo's clinical chemistry testing. This gap motivated the launch of a national pilot program.

The goal was to assess the performance of Togo’s government hospital labs in basic clinical chemistry. The study focused on 18 key tests. It aimed to identify areas where improvement was needed. The researchers wanted to compare lab results to WHO standards. They also examined the impact of automation on accuracy. The motivation was to guide future quality improvement efforts. No prior work had evaluated Togo’s lab performance in this way. The study aimed to inform national policy decisions.

The Division of Laboratories conducted a cross-sectional study from July to December 2016. They used test panels from One World Accuracy in Canada. The Clinical Laboratory Improvement Amendments criteria were used to evaluate results. Each lab tested 18 clinical chemistry parameters. Success rates were compared to WHO’s 80% target. The study included 11 government hospitals. Automated spectrophotometers were noted as a variable. Data were analyzed for trends across testing cycles.

Overall, six tests met or exceeded the 80% target: glucose, ALT, AST, GGT, ALP, and triglycerides. Labs using automated spectrophotometers had 89% acceptable results. The success rate varied between 71% and 82% across testing cycles. Urea, creatinine, and uric acid had the lowest performance. Cholesterol, bilirubin, and total protein also fell below the target. Calcium, magnesium, and phosphorus showed similar issues. The study found a strong link between automation and accuracy. These findings suggest a need for better internal quality control.

The study showed that some clinical chemistry tests in Togo met WHO standards. However, several tests required improvement. The researchers proposed extending the PT program to all labs. They emphasized the importance of internal quality control. The results suggest that automation improves accuracy. The program should cover all biology disciplines. The authors recommend expanding the initiative nationwide. These findings align with the study’s goal of improving lab performance.