Proficiency Testing of Viral Marker Screening in African Blood Centers — Seven African Countries, 2017
Authors: Bakary Drammeh, Syria Laperche, Joan F. Hilton, Zhanna Kaidarova, Larisa Ozeryansky, Anindya De, Mireille Kalou, Irene Benech, Bharat Parekh, Edward L. Murphy, Zaituni Abdallah, Abby Abdikadir, Usman Ali Medugu Abjah, Oluwafemi Adegbamigbe, Victoria Adeleke, Lara Adeyeye, Janet Agba, Stephen Ajala, Sheila Allotey, Peter Paul Bacheyie, Patrick Banda, Obasi Barnabas, Oriji O. Bassey, Diocleciano Bila, Frank Bonsu, Remi Caparros, Aglean Chelimo, Charles Chilambula, Lameck Chinkango, Armando Chongo, Francelino Luciano Chongola, Onyeka Paul Chuka, Samuel Cobbson, Leonardo Desousa, Elliot Eli Dogbe, Augusto Domingos, Vanetine Ebomwonyi, Rumji Elisha, Joanisse Samuel Escova, Esperança Fideliz, Jerry Gwamna, Dunstan Haule, Daniel Hindes, Tehreen Ismail, Rui Labissone Jemusse, Alberto João, Muluken Kaba, Nasibu Kabolile, Zachary Kibet, Sammy Kihara, Basilius Kilowoko, Daniel Kimani, Steve Kimanzi, Martha Kimamo, Richard Kinyaha, Nick Kiptanui, Khamisi Kithi, Festus Koech, Steve Kunyenga, Yusto Kyando, Alexander Lawrence, Chimwemwe Limited, Jorge Lucio, Simon Manu, Sylvester Mattunda, Nassim Mbarak,, Bridon Mbaya, Alice Mbui, Japheth Mdenyo, Rodgers MC Mengwa, Chidozie Meribe, Thom Mfune, Onoja Michael, Fernando José Muria, Andrew Mwamtobe, Musa Mwamzuka, Christina Mwangi, Deeps Mwenebanda, Allan Mungai, Antony Mungai, Jabir Muhsin, Venantia Mwajombe, Charles Mwiyuma, Emmanuel Nani, Henry Ndaki, Olivier Ndahiriwe, Daniel Ndhlovu, Macrina Nditi, Miguel Neves, Eviness Ngwira, Bernard Nkrumah, Peter Nzioka, Kingsley Odiabara, Elizabeth Odthiambo, Omo T. Ojo, McPaul Okoye, Mavis Okyere, Ogunkola Oluyemisi, Anthony Owusu-Ansah, John Provinseh, Thomas Rotich, Razak Saasi, Simon Sabaya, Tinache Gabriel Sabonete, Yaw Sam, Ibrahim Sani, Bamidele Sunday, Priscilla Tarimo, Adekoya Benson Tolulope, Peter Torokaa, Ndeonasia Towo, Erlinda Umoru, Jose Victorino, Kingsley Wuor, James Yelima, Samuila Yohanna
Journal: MMWR Morbidity and Mortality Weekly Report (2019)

A 2014 report evaluating accuracy of serologic testing for transfusion-transmissible viruses at African blood center laboratories found sensitivities of 92%, 87%, and 90% for detecting infections with human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV), respectively (1). Following substantial investments in national blood transfusion service (NBTS) laboratories, in 2017 investigators tested proficiency at 84 blood center laboratories (29 NBTS and 55 non-NBTS) in seven African countries. A blinded panel of 25 plasma samples was shipped to each participating laboratory for testing with their usual protocols based on rapid diagnostic tests (RDTs) (2) and third and fourth generation enzyme immunoassays (EIA-3 and EIA-4). Sensitivity and specificity were estimated using separate regression models that clustered assays by laboratory and adjusted for assay type and NBTS laboratory status. Mean specificities were ≥95% for all three viruses; however, mean sensitivities were 97% for HIV-positive, 76% for HBV-positive, and 80% for HCV-positive samples. Testing sensitivities for all viruses were high when EIA-3 assays were used (≥97%). Lower sensitivities for HBV-positive samples and HCV-positive samples were associated with assay types other than EIA-3, used primarily by non-NBTS laboratories. Proficiency for HIV testing has improved following international investments, but proficiency remains suboptimal for HBV and HCV testing. In sub-Saharan African blood centers, the quality of rapid tests used for HBV and HCV screening needs to be improved or their use discouraged in favor of EIA-3 tests.