Establishment of a Regional Iodine Resource Laboratory and External Quality Assessment Program at the Kazakh Academy of Nutrition

Abstract

Objectives: The need for and lack of iodine resource laboratories in Central and Eastern Europe led to an agreement between the Centers for Disease Control and Prevention (CDC) and UNICEF for developing a regional iodine reference laboratory at the Kazakh Academy of Nutrition (KAN).  Objectives included conducting reliable iodine measurements, KAN capacity strengthening, operating an external quality assurance (EQA) program, and self-sustainability.  An underlying aim was ensuring quality laboratory data for management and decision-making of iodine disorder elimination programs.  Methods: Creation of the laboratory at KAN was undertaken through technical support, training, funding, and material resources from CDC and UNICEF.  Initial activities included building a fully-functioning laboratory, developing partnerships, and creating and operating a website and EQA program.  Later activities included a landscape analysis, harmonized guidelines, an inaugural workshop attended by 17 regional laboratories, and a business sustainability plan. Results: The KAN reference laboratory was established and an operational plan is being implemented that will ensure sustainability. The plan includes contracts with the Kazakh government for multiple micronutrient analyses in four surveys, and fee-based trainings and assessments for regional laboratories as provided for Serbia, Kyrgyzstan, and Moldova. Participation in at least one EQA round by 78% of regional laboratories and consistent participation from 11/18 labs indicates that KAN assistance was well received.   Conclusions: An up-to-date, high-quality reference laboratory and resource center for iodine assessments, led by technical experts capable of managing reliable iodine measurements in salt and urine and coordinating an EQA service for national iodine laboratories, has been established in the region.