1. Dr. Gamaliel Gutiérrez Regional Dengue Program PAHO/WHO WDC
Project Proposal for monitoring the quality of diagnosis in the Dengue Laboratory Network of the Americas (RELDA)
Dr. Gamaliel Gutiérrez
Regional Dengue Program
PAHO/WHO WDC

2. Introduction
Diseases transmitted by vectors are a major global threat.
Climatic and social factors have: spread to previously uninfected areas.
It is a priority to strengthen national laboratories to guarantee a precise virological and epidemological surveillance of dengue and other arboviruses.
Chikingunya and Zika viruses have been recently introduced to the Americas

3. Vector Borne Diseases in the Americas, 2013-2015

5. Creation of RELDA
RELDA was created in 2008 and has as an objective to strengthen the technical and scientific capabilities of the laboratories of the Region.
RELDA is an important component of the Integrated Management Strategy for Dengue Prevention and Control (IMS-Dengue).

6. External Quality Control Program
It is necessary to introduce an external quality control program to:
Analyze the capabilities of each laboratory for the diagnosis of dengue through proficiency testing
Evaluate these capabilities in these laboratories and countries in the region
Implement a follow up plan to improve the capabilities for diagnosis

7. External Quality Assurance Program for the Diagnosis of Dengue
Proposal
Evaluate the capabilities of RELDA laboratories for the detection, identification, and characterization of dengue in Latin America and the Caribbean, using serological and molecular methods.
Coordination:
WHO, Regional Dengue Program of PAHO, RELDA, and the selected National Laboratories of Reference.
Collaborating Centers and the National Laboratories of Reference:
IPK
IEC
CDC
INEVH
InDRE
Participants:
20 Countries of Latin America and the Caribbean

8. External Quality Assurance Program for the Diagnosis of Dengue
Operational Methodology
Phase I: Project analysis
Phase II: Proficiency testing of the PAHO/WHO-CC
Phase III: Development and distribution of proficiency tests for RELDA participating laboratories
Phase IV: Global analysis of the results, publication, recommendations, and evaluation for the continuity and sustainability of the program

9. External Quality Assurance Program for the Diagnosis of Dengue
Phase I: Project Analysis
First Meeting:
Final proposal for the project for the monitoring the quality of diagnosis of dengue performed by RELDA members, using an EQA program, in coordination with and as part of a global system of WHO.

10. External Quality Assurance Program for the Diagnosis of Dengue
Phase II: Proficiency testing of the PAHO/WHO-CC
The Regional Dengue Program will send the invitations to the laboratories and the collaborating centers to participate in the proficiency testing.
The laboratories and collaborating centers will send their confirmation to participate in the program to the Regional Dengue Program.
The Regional Dengue Program will send the list of the participants to the World Health Organization.
The World Health Organization will send the sample panels to the participants.

11. External Quality Assurance Program for the Diagnosis of Dengue
Phase II: Proficiency testing of the PAHO/WHO-CC
The responsibilities of each collaborating center and national laboratory of reference are the following:
Receive the sample panels
Process and analyze the sample panels
Send the results to the designated collaborating center to consolidate the results

12. Phase II: Proficiency testing of the PAHO/WHO-CC

13. Phase III: Development and distribution of proficiency tests for RELDA participating laboratories

14. Figure 3: Map Distribution of the Countries Assigned to Each PAHO/WHO-CC and LNR

15. Phase IV Global analysis of the results. Publication.
Recommendations and follow up plan.
Evaluation for the continuity and sustainability of the program.

16. The new model of the IMS-Dengue, 2015

17. Questions and Comments?
Thank You!