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The TB Pathology program in Rwanda from 2007 -2010 was a groundbreaking initiative to introduce a comprehensive diagnostic testing method for suspected TB lymphadenitis in PLWHA. Our efforts under the guidance of the Rwandan MOH, National Reference Laboratory and the US CDC resulted in the training of over 100+ Clinicians, Laboratory Scientists and Pathologists from 2008 - 2010.

The training materials and questionnaires were created in English and French for Rwandan training initiatives to ensure that there were no language barriers and all material taught was accurately conveyed. The evaluations were disseminated before and after training workshops and the results were scored and recorded the marked increase in participants’ increased knowledge of the subject matter. The evaluations not only evaluated the participants’ ability to comprehend and dissect the subject matter, but also inquired the training itself. Some questions included: Did participants approve of the length of the training, the coordination, the acquired knowledge, the facilities, the break, the time allowed in lecture/practical exercises, discussion; the level of lessons and the content?  We also included the chance for participants to inquire about the quality of food provided at the trainings and the comfort of the venues.


Stevens, M.I., Gaatabazi, J.B.; Uwimana, I.; Ngendahayo, L., Gahimbare, L., Bigirimana, V., Kelley, W., Constantine, N..T.; Trifecta Method of Fine Needle Aspiration, Multiple Staining Techniques and Expedited Results Reporting for Diagnosis of Suspected Extrapulmonary and MDR-TB Lymphadenopathies, and HIV Opportunistic Infection Variants in Resource Limited Countries,; 28th International Congress of the International Academy of Pathology; Sao Paulo, Brazil October 2010.

In Nigeria, in addition to information we received from mentoring workshop surveys, we operated an External Quality Assurance Program for HIV testing laboratories where we would submit monthly and quarterly data samples in a blinded panel for the 37 individual laboratories tested. Once the tests were completed the individual laboratories would have to complete a handwritten results reporting form which would be scanned and emailed to the US. These results forms would be entered into an EXCEL spreadsheet which contained automatic formulas for calculating the ranges of acceptable and unacceptable results. These ranges would indicate if a laboratory would pass or fail the blinded panel challenges with a +/-3 reliability 97% confidence level. Since its inception this EQA program has increased the quality of HIV testing and results reporting, including a marked decrease in transcriptional errors, in Nigeria and the results were published in the 2008 PEPFAR Implementers Meeting in Uganda.


Croxton, T., Jugu, J., Okelade, O., Stevens, M., Abimiku, A., Blattner, W., Constantine, N., The Most Common Quality Assurance Deficiencies in PEPFAR ACTION Supported Laboratories in Nigeria 2008 HIV/AIDS Implementers’, Meeting; Kampala, Uganda

Since 2006 our efforts in resource limited countries including PEPFAR supported initiatives have contributed to the training of over 650 members of the healthcare workforce. Our work with key implementing partners has fostered international support from donors and the scientific community.

The summary of our activities from 2006 - 2009 were accepted into the 22nd European Congress of Pathology and presented by the Managing Principal in September 2009 in Florence, Italy.

Stevens, M.I., Croxton, T., Kelley, W., Constantine, N. Application Of The Scientific Method To Create And Implement Sustainable Pathology and General Laboratory Services Programs in Resource Limited Countries For PLWHA, 2009 European Congress of Pathology; Florence, Italy

Area Committee Member/Observer

  •   Quality Systems and Laboratory Practices
  •   Point of Care Testing​
  •   Evaluation Protocols​
  •   EP18-A2 Risk Management Techniques to Identify and Control  Laboratory Error Sources

Sub-Committee Member/Observer

  •   Planning for Challenges to Clinical Laboratory Operations During a Disaster​
  •   GP-17 Clinical Laboratory Safety​
  •   Non-gynecologic Cytologic Specimens: Collection and Cytopreparatory Techniques​
  •   Management and Leadership Roles and Responsibilities.​
  •   Quality Management Systems


Contributed and participated in the reivew of the following Clinical Laboratory Standards Institute (CLSI) published documents


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