External quality assessment for tuberculosis diagnosis and drug resistance in the European union: A five year multicentre implementation study

Vladyslav Nikolayevskyy, Doris Hillemann, Elvira Richter, Nada Ahmed, Marieke J. Van Der Werf, Csaba Kodmon, Francis Drobniewski, Sabine Ruesch-Gerdes

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)


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.

Original languageEnglish
Article numbere0152926
JournalPLoS ONE
Issue number4
Publication statusPublished - Apr 2016

Bibliographical note

Publisher Copyright:
© 2016 Nikolayevskyy et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Copyright 2016 Elsevier B.V., All rights reserved.


Dive into the research topics of 'External quality assessment for tuberculosis diagnosis and drug resistance in the European union: A five year multicentre implementation study'. Together they form a unique fingerprint.

Cite this