{ "abstract": "The External Quality Assessment (EQA) for Africa (EQuAFRICA) project aimed at building regional capacity to provide a One Health bacteriology proficiency testing (PT) programme for reference and sentinel laboratories supporting antimicrobial resistance (AMR) surveillance and submission of data to the World Health Organization Global Antimicrobial Resistance and Use Surveillance System (WHO GLASS). We analysed the performance of participating laboratories in pathogen specific identification (ID) and qualitative antimicrobial susceptibility testing. The programme covered all GLASS and other bacterial pathogens of importance. One survey was distributed in 2021 and 2023 and two surveys in 2022, 2024 and 2025, with five isolates per survey. Participants were selected among reference and designated sentinel AMR laboratories from the 14 Fleming Fund recipient countries in Africa. The Clinical Microbiology Proficiency Testing (CMPT) marking scheme was used to score performance. The number of invited, enrolled and responding laboratories differed by survey; an average of 85% of enrolled laboratories submitted results. Participants scored 83% for organism ID across all cycles. Microbiology laboratories from the human health sector represented the majority in all cycles (75%). The average scores for antibiotic susceptibility testing (AST) was 73%, no participants that scored zero. Critical AST errors with clinical implications for directed treatment included vancomycin and cefoxitin for staphylococci. Our manuscript highlights that the use of EQA programmes to detecting gaps in laboratory processes and maintaining the quality and accuracy of AST is vital for effective AMR surveillance and control. This report illustrates that poorly performed AST at the beginning of the programme improved over the time. Building sustainable capacity for bacteriology testing, including AST, is critically important at all laboratory levels across Africa, from routine clinical and surveillance sites to national AMR reference laboratories.", "abstract_shown": true, "affiliations": [ "National Institute for Communicable Diseases (NICD) a division of National Health Laboratory Service, Johannesburg South Africa", "School of Pathology, University of Witwatersrand, Johannesburg, South Africa", "African Society for Laboratory Medicine (ASLM), Addis Ababa, Ethiopia", "African Field Epidemiology Network (AFENET), Kampala, Uganda", "Amref Health Africa (Amref), Nairobi, Kenya", "Pôle de Microbiologie, Institut Pasteur de Dakar, Dakar, Sénégal", "National Food Institute (DTU Food), at Technical University of Denmark, Lyngby, Denmark", "Africa Centre for Diseases Control and Prevention (Africa CDC), Addis Ababa, Ethiopia", "The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland", "Amsterdam Institute for Global Health and Development, Department of Global Health, University of Amsterdam, Amsterdam, the Netherlands" ], "article_type": "Research Article", "arxiv": null, "author_total": 14, "authors": [ { "affs": [ 0, 1 ], "name": "Olga Perovic", "orcid": "0000-0001-5580-4629" }, { "affs": [ 2, 3 ], "name": "Beatrice van der Puije" }, { "affs": [ 4 ], "name": "Jane Y. Carter", "orcid": "0000-0003-4671-3519" }, { "affs": [ 2 ], "name": "Felix Humwa" }, { "affs": [ 0 ], "name": "Rubeina Badat", "orcid": "0009-0002-5176-4118" }, { "affs": [ 4 ], "name": "Dennis Mwiti", "orcid": "0009-0006-5295-6866" }, { "affs": [ 0 ], "name": "Marshagne Smith" }, { "affs": [ 5 ], "name": "Fatime Poulo Ly", "orcid": "0009-0007-4641-2595" }, { "affs": [ 5 ], "name": "Cheikh Fall" }, { "affs": [ 5 ], "name": "Yakhya Dièye" }, { "affs": [ 2 ], "name": "Patience Dabula" }, { "affs": [ 6 ], "name": "Rene S. Hendriksen", "orcid": "0000-0003-2934-8214" }, { "affs": [ 7 ], "name": "Yenew Kebede Tebeje" }, { "affs": [ 2, 8, 9 ], "name": "Pascale Ondoa" } ], "bibtex": "https://research.draconitic.com/paper/84k9aaqevpj12.bib", "cited_by": 0, "doi": "10.1371/journal.pgph.0007478", "fulltext_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007478", "id": "84k9aaqevpj12", "issns": [ "2767-3375" ], "landing_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007478", "language": "en", "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Africa" ], [ "heading", "Agriculture" ], [ "heading", "Animal Management" ], [ "heading", "Animal Performance" ], [ "heading", "Antibiotic Susceptibility Testing" ], [ "heading", "Antibiotics" ], [ "heading", "Antimicrobial Resistance" ], [ "heading", "Antimicrobials" ], [ "heading", "Bacterial Pathogens" ], [ "heading", "Bacteriology" ], [ "heading", "Biology and Life Sciences" ], [ "heading", "Drugs" ], [ "heading", "Geographical Locations" ], [ "heading", "Government Laboratories" ], [ "heading", "Gram Negative Bacteria" ], [ "heading", "Medical Microbiology" ], [ "heading", "Medicine and Health Sciences" ], [ "heading", "Microbial Control" ], [ "heading", "Microbial Pathogens" ], [ "heading", "Microbiology" ], [ "heading", "Pathogens" ], [ "heading", "Pathology and Laboratory Medicine" ], [ "heading", "People and Places" ], [ "heading", "Pharmacologic Analysis" ], [ "heading", "Pharmacology" ], [ "heading", "Research Article" ], [ "heading", "Research Facilities" ], [ "heading", "Research Laboratories" ], [ "heading", "Research and Analysis Methods" ], [ "openalex", "1308|Bacterial Identification and Susceptibility Testing" ], [ "plos", "/Biology and life sciences/Agriculture/Animal management/Animal performance" ], [ "plos", "/Biology and life sciences/Microbiology/Bacteriology/Gram negative bacteria" ], [ "plos", "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Bacterial pathogens" ], [ "plos", "/Biology and life sciences/Microbiology/Microbial control/Antimicrobial resistance" ], [ "plos", "/Biology and life sciences/Microbiology/Microbial control/Antimicrobials/Antibiotics" ], [ "plos", "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Bacterial pathogens" ], [ "plos", "/Medicine and health sciences/Pharmacology/Antimicrobial resistance" ], [ "plos", "/Medicine and health sciences/Pharmacology/Drugs/Antimicrobials/Antibiotics" ], [ "plos", "/Medicine and health sciences/Pharmacology/Pharmacologic analysis/Antibiotic susceptibility testing" ], [ "plos", "/People and places/Geographical locations/Africa" ], [ "plos", "/Research and analysis methods/Research facilities/Research laboratories/Government laboratories" ] ], "openalex": "W7223807822", "pdf_url": "https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0007478&type=printable", "pmcid": "PMC13712707", "pmid": "42945389", "published": "2026-10-27", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/84k9aaqevpj12.ris", "sources": [ { "first_seen": "2026-10-30T12:17:17Z", "native_id": "10.1371/journal.pgph.0007478", "source": "plos", "url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007478" }, { "first_seen": "2026-10-31T12:23:14Z", "native_id": "PMC13712707", "source": "pmc", "url": "https://doi.org/10.1371/journal.pgph.0007478" } ], "subjects": [ { "field": "biology", "origin": "plos:microbiology", "subfield": "microbiology" }, { "field": "medicine", "origin": "plos:pharmacology", "subfield": "pharmacology-toxicology" } ], "title": "Laboratory performance of antimicrobial susceptibility testing for GLASS pathogens among participants in the EQuAfrica programme, 2021‒2025", "title_text": "Laboratory performance of antimicrobial susceptibility testing for GLASS pathogens among participants in the EQuAfrica programme, 2021‒2025", "type": "peer-reviewed", "updated_at": "2026-10-31T12:23:14Z", "url": "https://research.draconitic.com/paper/84k9aaqevpj12", "venue": "PLOS Global Public Health", "versions": [] }