1. Continuous Quality Improvement of Laboratory Services Supporting HIV/AIDS Care and Treatment Programs in Tanzania
M. Majigo1, L. Mwambebule1, J. Mangu1, D. Mkembela1, O. Maleo1, D. Simpungwe1, F. Marinucci2
1Institute of Human Virology, University of Maryland School of Medicine, Laboratory, Dar es Salaam, United Republic of Tanzania, 22Institute of Human Virology, University of Maryland School of Medicine, Laboratory, Baltimore, United States
INTRODUCTION
Quality medical laboratory services play a crucial role in supporting HIV/AIDS care and treatment programs. Aspects such as safety, documentation, equipment maintenance, inventory management, and internal quality procedures are critical factors for a functional quality laboratory service. In order to ensure quality these aspects need to be continuously monitored and evaluated
METHODS
To address the gaps in these areas among the laboratories the Institute of Human Virology, University of Maryland School Of Medicine (IHV-UMSOM) supports in Mara, Mwanza, Manyara, and Tanga regions in Tanzania proprietary tools for laboratory quality improvement were developed. These tools focused on total testing procedure for CD4 T-cell count, malaria and Acid-Fast Bacilli (AFB) microscopy and comprised close ended questions on 12 topics. The laboratories were graded as 'Unsatisfactory' for total score below 65%, 'Satisfactory' between 65 and 74%, 'Good' between 75 and 84%, and 'Excellent' above 85%. Corrective actions discussed with laboratory staff and implemented accordingly
Results
A total of 23, 28, and 30 laboratories were assessed once for CD4 T-cell count, malaria, and AFB microscopy respectively and among these 12, 13, and 19 were monitored overtime and received 2 to 3 mentoring visits. Baseline scores at 4/12, 4/13 and 14/19 laboratories for CD4, malaria, AFB microscopy were unsatisfactory; while at 0/12, 2/13, and 1/19 laboratories the scores were excellent. At the last assessment the total scores increased at 10, 8, 19 laboratories with a total of 0, 3, and 6 laboratories with unsatisfactory score for CD4, malaria, AFB microscopy respectively
CONCLUSIONS
The laboratory quality improvement tools showed to be helpful in assessing, improving, and monitoring the quality of total testing procedure for CD4, malaria, and AFB microscopy. Combining the use of these tools with regular mentorship visits at site level is very effective for Continuous Quality Improvement to strengthen the quality of laboratory services regardless of their location and level. 
ACKNOWLEDGEMENTS
All laboratories providing care and treatment services in local partner treatment facilities supported by the AIDSRelief program. The US President’s Emergency Plan for AIDS Relief (PEPFAR); The AIDSRelief Consortium; The Health Resources and Services Administration; The Center for Disease Control and Prevention (CDC).
Presented at AIDS 2012 – Washington, D.C., USA