QASI-LI (Quality Assessment and Standardization of Indicators Relevant to HIV/AIDS - Leucocyte Immunophenotyping)

QASI, the Public Health Agency of Canada’s International Program for Quality Assessment and Standardization of Indicators relevant to HIV/AIDS is located at the National HIV and Retrovirology Laboratories in Winnipeg, Canada. QASI provides external quality assurance (EQA) through administration of proficiency testing (PT) panels and comprehensive corrective and preventative action as required in English, French and Spanish. There are three EQA programs currently available; QASI-LI (Leukocyte Immunophenotyping), QASI-EID (Early-Infant Diagnosis) and QASI-VL (Viral Load).

The QASI-LI program has been in operation since 1996, originally based in Ottawa. QASI-LI has a mandate to provide EQA to testing sites in resource limited countries performing CD4+ T cell enumeration utilizing both point-of-care (POC) technologies as well as conventional flow cytometry. CD4+ T cell counts remain an important indicator of a patient’s immune and clinical status, as well as a critical indicator of immune status at time of diagnosis to assess the risk for development of opportunistic infections.

The QASI-LI program operates on a 2-tiered system.  QASI can either interact directly with a participant or through in-country coordinators. When interacting directly, all communications, shipments and dialogue takes place between the QASI team and the laboratory.  When a coordinator for a region exists, that individual takes on the role of communications, receiving and redistributing samples to all participants enrolled in that region, interacting with participants and assistance with data submission and corrective action events.  The ultimate goal is for QASI to assist a coordinator in developing and launching their own National EQA program.

Frequency of distribution: QASI-LI operates on a bi-annual testing scheme, providing 3 stabilized whole blood preparations per session to enrolled participants according to a pre-established shipping schedule.  A notification is sent via email to each participant prior to the survey.  The laboratory confirms their participation via email.  Samples are sent by courier, using air transportation.

Data collection takes place through a web database platform. QASI provides feedback in the form of individual Performance Reports for each testing site, and a comprehensive Assessment Report for Coordinators, which details overall performance, non-conformances, and recommended corrective actions as required.  Corrective action is a critical component of QASI-LI to ensure participants correctly identify problems and strategies to improve them.

To ensure accurate and reliable CD4+ T cell enumeration through the provision of proficiency testing panels, external quality oversight and comprehensive and preventative action recommendations in countries where EQA services are limited or unavailable.

QASI-LI focuses on improving the quality of laboratory practices of immunophenotyping by both POC technologies as well as by conventional flow cytometry methods, as CD4+ T cellcounts are an important indicator of a patient’s immune and clinical status as well as managing and treating opportunistic infections.

There is no fee to enrol or participate in the QASI-LI program.  

Eligible participants are those sites actively performing tests for CD4 enumeration using either conventional flow cytometry (including the BD Biosciences FACS Calibur, FACS Canto/ II, FACS Count, Beckman Coulter FC500, Navios and Partec CyFlow instruments) or POC technologies (including the Abbott PIMA and BD Biosciences FACS Presto instruments).

Confidentiality of testing results and performance is maintained using a password protected online database and numerical laboratory IDs to distinguish testing sites

Please contact qasi@phac-aspc.gc.ca to apply for any of our EQA programs.