TY - JOUR T1 - External quality assessment for tuberculosis diagnosis and drug resistance in the European Union: A five year multicentre implementation study JF - PLoS.One. Y1 - 2016 A1 - V Nikolayevskyy A1 - Hillemann,D. A1 - Richter,E. A1 - Ahmed,N. A1 - van der Werf,M.J. A1 - Kodmon,C. A1 - Drobniewski,F. A1 - Ruesch-Gerdes,S. KW - 0 KW - a KW - accuracy KW - Activity KW - Agent KW - Agents KW - ALL KW - Amikacin KW - Antitubercular Agents KW - Area KW - article KW - AS KW - assessment KW - Benefit KW - benefits KW - Clinical Laboratory Techniques KW - Common KW - Control KW - conventional KW - detection KW - developing KW - Diagnosis KW - disease KW - DRUG KW - Drug Resistance KW - Drug Resistance,Bacterial KW - ECONOMIC KW - electronic KW - EQA KW - European KW - European Union KW - external KW - External quality assessment KW - Germany KW - Humans KW - identification KW - identify KW - im KW - implementation KW - improve KW - IS KW - journal KW - Laboratories KW - LEVEL KW - london KW - method KW - methods KW - Molecular KW - Mycobacterium KW - n KW - national KW - need KW - needs KW - Network KW - Nontuberculous Mycobacteria KW - PARTICIPANTS KW - Participation KW - performance KW - prevention KW - problems KW - Pyrazinamide KW - Quality KW - QUALITY ASSURANCE KW - resistance KW - result KW - results KW - SB - IM KW - specific KW - State KW - States KW - study KW - Sweden KW - System KW - Systems KW - Test KW - TESTING KW - training KW - Tuberculosis KW - United Kingdom KW - United-kingdom AB - BACKGROUND: External quality assurance (EQA) systems are essential to ensure accurate diagnosis of TB and drug-resistant TB. The implementation of EQA through organising regular EQA rounds and identification of training needs is one of the key activities of the European TB reference laboratory network (ERLTB-Net). The aim of this study was to analyse the results of the EQA rounds in a systematic manner and to identify potential benefits as well as common problems encountered by the participants. METHODS: The ERLTB-Net developed seven EQA modules to test laboratories' proficiency for TB detection and drug susceptibility testing using both conventional and rapid molecular tools. All National TB Reference laboratories in the European Union and European Economic Area (EU/EEA) Member States were invited to participate in the EQA scheme. RESULTS: A total of 32 National TB Reference laboratories participated in six EQA rounds conducted in 2010-2014. The participation rate ranged from 52.9% - 94.1% over different modules and rounds. Overall, laboratories demonstrated very good proficiency proving their ability to diagnose TB and drug-resistant TB with high accuracy in a timely manner. A small number of laboratories encountered problems with identification of specific Non-tuberculous Mycobacteria (NTMs) (N = 5) and drug susceptibility testing to Pyrazinamide, Amikacin, Capreomycin, and Ethambutol (N = 4). CONCLUSIONS: The European TB Reference laboratories showed a steady and high level of performance in the six EQA rounds. A network such as ERLTB-Net can be instrumental in developing and implementing EQA and in establishing collaboration between laboratories to improve the diagnosis of TB in the EU/EEA VL - 11 CP - 4 U1 - 37168 M3 - http://dx.doi.org/10.1371/journal.pone.0152926 ER -