External Quality Assurance Programme [EQAP]

PPTC WHO CC-1

The Pacific Pathology Training Centre is a World Health Organization Collaborating Centre [WHOCC] for External Quality Assessment [EQA] in Health Laboratory Services.

Participation in the EQA for 23 national laboratories in the South Pacific region including Timor Leste is funded by the New Zealand overseas development programme.

The terms of reference for this collaboration is listed below:

To assist WHO in the organisation and provision of external quality assessment programmes in Microbiology, Infectious Disease Serology, Biochemistry, Haematology, and Blood Transfusion Science for laboratory services of developing countries in the Pacific region.
To assist WHO in providing training of laboratory personnel to strengthen quality assurance programmes of laboratories in the Member States and to develop a skilled workforce of laboratory technicians.
To assist WHO in providing technical support and advice as required in the strengthening of health laboratories in the Pacific region.

Overview

The PPTC REQA programme originally commenced in 1985 as an evaluation process for students attending residential courses in New Zealand. This was updated in 1990 when the PPTC was conferred Collaborating Centre status by WHO. The EQAP further expanded in 2000, and then in 2004 with the introduction of a regular HIV/STI testing component. In 2017, the programme was expanded to include Dengue testing and in 2019, Anatomical Pathology was introduced.

In June 2019, the PPTC changed its operating name from Pacific Paramedical Training Centre to Pacific Pathology Training Centre. The Pacific Pathology Training Centre became a WHO Collaborating Centre for External Quality Assessment in Health Laboratory Services in June 2020.

Pacific laboratories differ considerably in the levels of instrumentation, equipment, methodology and expertise available to them and thus the evaluations of the responses received from them must recognise these different levels of technology.

The major purpose of this programme is to actively help and suggest ways in which a laboratory can improve the quality of its service to the patient. The Centre’s staff have visited the majority of laboratories presently enrolled in the programme and funding is received from the New Zealand Ministry of Foreign Affairs & Trade [MFAT - NZ overseas development programme] and the New Zealand Insitute of Medical Laboratory Sciences [NZIMLS].

In 2021 there are approximately 90 laboratories from 20 countries participating in all or part of the programme and these include:

23 National Laboratories (Pacific Island Countries)

9 Divisional Laboratories (Pacific Island Countries)

3 Laos PDR Laboratories

40 Cambodia Laboratories

2 Timor Leste Laboratory

3 Bhutan Laboratory

10 Private Laboratories

Laboratories are given five weeks to process the survey and return their results to the Centre. A final reply also details the laboratory score for the exercise, their accumulated score for the previous dispatch in that discipline, and the average score for all participating laboratories.

Each laboratory is identified by a unique code number, with the generated results kept confidential to that laboratory, the PPTC, the WHO Regional Adviser of Health Laboratories at the Regional Office in Manila, and the relevant department at the NZ Ministry of Foreign Affairs and Trade in Wellington.

EQA Panels

The following medical laboratory sciences disciplines are currently offered by the PPTC:

Anatomical Pathology Panel - consists of 3 surveys per year. Each survey consists of 4 to 6 unstained tissue biopsies mounted on microscope slides, with relevant clinical details. Laboratories are required to stain each slide and Pathologists examine the tissue slides and report on the microscopic findings, provide a target diagnosis and answer disease-specific questions to support the diagnosis. The PPTC acknowledges the support from Wellington SCL Anatomical Pathology Department, Wellington Hospital for preparing the cases.
Biochemistry Panel - consists of 2 surveys per year. Each survey has 4 lyophilised serum samples and 4 samples of reconstituting fluid for general chemistry analysis together with 3 samples for glycated haemoglobin [HbA1c] analysis. PPTC acknowledges the support provided by RCPAQAP for the donation of samples for this Biochemistry programme.
Haematology Panel - consists of 3 surveys per year. Each survey consists of three stained blood films with relevant clinical case scenarios. Laboratory staff are required to examine each slide under a microscope and report on white cell, red cell and platelet morphology and provide a clinical comment to be reported for patient diagnosis and management. The PPTC thanks the WSCL and LabPLUS for the occasional supply of samples for this survey.
Microbiology Panel - consists of 3 surveys per year. Each survey consists of three pathogenic organisms for identification and, if necessary, antimicrobial susceptibility testing. A range of both gram-positive and gram-negative organisms are included and on occasion, a more fastidious organism may also be sent. Cultures will either be lyophilised or sent on solid media. A parasitology case study is also included with each survey. On occasion, mixed cultures, samples requiring urine cell count, and gram stains may also be included as sample types. The PPTC thanks the RCPAQAP and WSCL for the occasional donation of samples for our Microbiology programme.
Molecular SARS-CoV-2 Panel - This panel was established in 2020 in response to the COVID-19 pandemic through WHO funding. 3 surveys are distributed each year. Each survey consists of three heat deactivated nasopharyngeal samples in VTM from potential positive COVID-19 patients. Laboratories are required to perform all the molecular virology disease screening tests that are routinely carried out on suspected COVID-19. The samples can be tested on more than one platform. The PPTC acknowledges the support from ESR in running this programme.
Serology/ Infectious Diseases Panel - consists of 3 surveys per year. Each survey contains at least 5 serum samples for the laboratory to perform the tests they would use in screening a potential blood donor. Normally this would include Hepatitis B surface antigen, a test for syphilis, and also for HIV 1 & 2 and Hepatitis C antibodies. Samples may be lyophilised or sent as liquid serum samples. On occasion, two additional samples are provided for Dengue testing. The PPTC thanks the NZBS for the donation of blood products and the CHL’s for the positive samples.
Transfusion Science/ Blood Bank Panel - consists of 3 surveys per year. Each survey consists of blood and serum from a ‘recipient’ and three samples of red cells from possible ‘donors’. The laboratories are required to carry out blood grouping (ABO and Rh) on each sample and crossmatch the donor’s samples with those of the patients. Occasionally, antibodies are included to ensure some donors are incompatible. The PPTC thanks the NZBS for the donation of blood products.

Acknowledgement

The PPTC acknowledges the funding support received from the New Zealand Ministry of Foreign Affairs & Trade [MFAT, NZ Aid Programme] to provide a free service to approximately 30 National Hospitals in the Pacific Region. Through MFAT funding the PPTC is able to sustain its EQA programme, using the funding to pay for courier services, cost of samples, consumables and supplies, and consultant fees for specialist Medical Laboratory Scientists and Pathologists.

The PPTC further acknowledges the support of the Royal College of Pathologists of Australasia Quality Assurance Programs [RCPAQAP - Sydney, Australia], Wellington Southern Community Laboratories [WSCL - Wellington Hospital, NZ], Canterbury Health Laboratories [CHL - Christchurch Hospital, NZ], New Zealand Blood Services [NZBS - Wellington and Christchurch, NZ], LabPLUS [Auckland Hospital, Auckland, NZ] and Institute of Environmental Science and Research – [ESR - Wellington, NZ] for the contribution of samples for our EQA programme. Untitled

2021 EQA Registrations

Please complete and email the registration form to pptc@pptc.org.nz. Click to download the form here: REQA Registration Form

2021 Dispatch Schedule:

You may download the 2021 PPTC EQA Dispatch Schedule here - 2021 PPTC EQA Dates Participant Copy

For further information contact: Filipo Faiga, Programme Manager, PPTC, PO Box 7013 Wellington, New Zealand Telephone: 64 4 389 6294 Email: filipo@pptc.org.nz