Feasibility and potential impact of a local proficiency testing program in Accra, Ghana

To implement a pilot proficiency testing (PT) program in Accra, Ghana, using locally produced PT materials and to explore the relationship between laboratory test costs and laboratory quality in Accra, Ghana.

Remnant serum samples from a local laboratory were pooled, aliquoted, and distributed to a convenience sample of 23 laboratories in Accra, Ghana, 2 of which had International Organization for Standardization (ISO) accreditation. One of the ISO-accredited laboratories was designated as the reference/target, and the range for passing was based on international criteria. Test cost, test results, and testing instruments used were compiled.

Of the 23 laboratories, 18 submitted results. Total testing costs ranged from 80 to 312 Ghanaian cedi (GH₵) (7-26 USD). Overall accuracy (pass rate) was calculated per laboratory and per analyte. The mean laboratory accuracy was 61% (15%-92%). The pass rate for individual analytes ranged from 18% to 94% (mean, 72%). There was no correlation between test cost and pass rate.

The pass rates of clinical laboratories in Accra, Ghana, varied from 15% to 92%, and there was no relationship to test cost. A PT program to objectively evaluate each laboratory's performance is needed. Making the PT material locally, as in this study, is a financially sustainable approach.