Diagnostics
Toward a National Tuberculosis Lateral-Flow Urine Lipoarabinomannan (LF-LAM) External Quality Assessment Program in Thailand: Feasibility Demonstration Through Panel Development, Validation, and Proficiency Testing, March 2025–April 2026
By Supaporn Suparak, Theerawit Tasaneeyapan, Petai Unpol and 15 others.
Abstract
Background
The World Health Organization and the Thailand National HIV Treatment Guidelines recommend the use of lateral flow urine lipoarabinomannan (LF-LAM) testing for tuberculosis (TB) detection in people living with HIV (PLHIV) with advanced HIV disease who have signs and symptoms of TB or are seriously ill. As Thailand decentralizes LF-LAM testing, a robust quality assurance system is needed to maintain diagnostic accuracy across healthcare levels.
Methods
We developed, validated, and rolled out Thailand’s first national external quality assessment (EQA) and internal quality control (IQC) framework for urinary TB LF-LAM testing. Pre-characterized urine panels were distributed to 20 provinces spanning 12 health regions nationwide across four cycles from 2025 to 2026. Longitudinal monitoring of reporting compliance, pass rates, and failure modes was performed across 30 participating sites in 2025 and 64 and 42 sites in 2026 Rounds 1 and 2, respectively.