External Quality Assessment Performance and Associated Factors in Selected Governmental Clinical Bacteriology Laboratories in Ethiopia
Creators: name: Assefa, Dawit
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2019

description: Background: External quality assessments (EQA) at various level of the health system are very helpful in the identification of possible nonconformance in laboratory. Moreover, it helps develop guidelines for remedial actions to be taken for the improvement of laboratory services with ultimate goal of attaining better health care and patient outcome. Objective: To assess selected government clinical bacteriology laboratories external quality assessment performance and associated factors in Ethiopia from July 2018 up to May 2019. Methods: A cross sectional study design using both a prospective and retrospective data approach was employed among 16 bacteriology laboratories from July 2018 to May 2019. From One world accuracy PT sample provider they obtained seven panel tests: bacterial identification from sputum, blood, eye swab, wound and CSF; throat swab; urine; genital; N. gonorrhoea identification; gram stain; and AST. In addition, four standard bacterial strains were prepared in house and distributed to participant laboratories. Data were collected using pre-tested structured questionnaire as well as on-site observation. The collected data was cleaned and analyzed using Stata14.2 and exact logistic regression. P &lt;0.05 was considered as statistically significant. Results: The overall failure rate of bacterial identification during event two from CSF, blood and Abdominal abscess, was 7/13(53.8 %); from throat culture 8/13(61.5%), from urine 5/13(38.46%), and from genital cultures 8/13(61.5%) from gram staining 7/15(46.6%) and for N. gonorrhea ID the failure rate was 2/14(14.2%). On the other hand, the failure rate from event three were: from sputum, blood and eye swab 14/16 (87.5 %), from urine 7/16(43.8%), from throat 8/15(53.3%), from genital culture 9/16(56.3%), from gram staining 5/16(31.3%) and for N.gonorrhoea ID the failure rate was 7/15(46.7%). The overall AST failure rate of the laboratories during event 2 and 3 were 8/10(80%), and 8/13(62%) respectively. Fifteen laboratories were participated in house prepared PT samples for bacterial ID and AST were the failure rate from pus 1/15(6.66%),sputum 3/15(20%),blood 5/15(33.3%),AST 1/15(6.66%) .The foremost identified contributing factories for unsuccessful PT results includes mis utilization of updated SOPs, no use of McFarland standard, unable to perform internal quality control for Gram staining, culture media, identification reagents, and antibiotic discs (p&lt;0.05). Conclusion: The overall EQA performance of participant clinical bacteriology laboratories was poor. The main associated factors were poor implementation of quality management system such as poor records and documentation, poor internal quality control practices, no regular competency assessment, VII lack of refreshment on basic microbiology training Therefore, continues training and mentorship for laboratories participating in external quality assurance are mandatory.