April 2017: Workshop on Hepatitis Strategic Information and Laboratory Capacity, Mongolia
The World Health Organization (WHO) Western Pacific Regional Office (WPRO) aims to establish the first Regional Hepatitis Reference Laboratory Network based on existing networks for HIV, measles and rubella. WHO WPRO is also seeking to further develop disease surveillance mechanisms in the region. To this end a Workshop organised by WHO, was held in Ulaanbaatar, Mongolia and attended by 90 public and private laboratory staff and managers, clinicians, and epidemiologists. NRL was represented as one of the facilitators, along with medical, surveillance and laboratory staff from the Doherty Institute/Victorian Infectious Disease Reference Laboratory, US CDC, Korean CDC and the WHO.
To assist in the development of the Regional Hepatitis Reference Laboratory Network, NRL and VIDRL created a laboratory capacity survey and a self-assessment tool that were piloted at a workshop in Mongolia. Prior to the workshop a questionnaire, translated into Mongolian, was distributed by the WHO Country Office to public and private laboratories throughout the country. The questionnaire was comprehensive and included questions relating to hepatitis A, B, C, D and E. It was comprised of 90 questions, many with sub-questions, reviewing the type of testing performed, participation in quality assessment schemes, testing of quality control samples, presence of testing strategies, referral of samples and reporting of surveillance data. The results of the survey were translated back to English and returned to the collaborating Australian laboratories for analysis. A second self-assessment tool was developed. This tool had seven sections – laboratory organisation, specimen management, testing and process control, quality assurance, data management, reagent and equipment procurement and laboratory safety. Each section contained a series of points relating to the section’s topic. The workshop participants rated each point from 1 to 4, where 1 was “not present/not available” and 4 was “complete and functional”.
The results of the survey and the assessment tool identified gaps in the testing capacity. These gaps in laboratory capacity, along with recommended actions, were reported to the WHO regional office and the Mongolian Ministry of Health. Similar surveys and workshops will be conducted in other WPRO Member States. WPRO (and their collaborators) have committed to organise national workshops in 5 further high burden countries in the coming 12 months (China, Philippines, Laos, Vietnam and Cambodia).