Assessment of Gene-Xpert MTB RIF Program Implementation and the Challenges For Enhanced Tuberculosis Diagnosis in Nigeria

Gidado, Mustapha; Jumoke, O; Nwadike, Peter; Emeka, E. N.; Akang, Gabriel; Eneogu, Rupert; Chukwueme, Nkem; Aliyu, Gambo; Bhatta, Gakul

doi:10.3126/saarctb.v12i2.15948

Cited by 9 publications

(19 citation statements)

References 20 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition to data sources, factors such as defective modules, staff experience, and cartridge version (G3 vs. G4) could affect the occurrence of unsuccessful results [31, 32]. On the other hand, relatively lower unsuccessful rate reported by Ardizzoni et al [32] and Mustapha et al [33]. However, laboratory register used as a sole data source for Xpert data and may not capture the initial test outcomes in case of test failures.…”

Section: Discussionmentioning

confidence: 99%

Monitoring quality indicators for the Xpert MTB/RIF molecular assay in Ethiopia

et al. 2019

View full text Add to dashboard Cite

IntroductionIn Ethiopia, >300 GeneXpert instruments have been deployed for tuberculosis (TB) testing using the Xpert MTB/RIF cartridge. Implementing quality indicators is necessary for monitoring and evaluating the quality of Xpert MTB/RIF diagnostic services.ObjectiveTo assess the use of quality indicators for the Xpert MTB/RIF molecular assay in Ethiopia and to compare the findings with the predefined targets described in the literature.MethodsClinical specimens collected from patients with suspected TB were subjected to Xpert MTB/RIF testing at the National TB Reference Laboratory (NTRL) between January and December 2018. Data were collected from GeneXpert software and Laboratory Information System (LIS) databases. Quality indicators were calculated and analyzed. Bivariate and multivariate analyses were performed using SPSS software version 20 (SPSS Inc., Chicago, Illinois, USA).ResultsOf the 2515 specimens tested, 2274 (90.4%) had successful test results; 18.2% were positive for Mycobacterium tuberculosis (MTB). Among MTB positives (n = 413), 4.8% and 1.0% were rifampicin (RIF)-resistant and RIF-indeterminate cases, respectively. Unsuccessful results were 241 (9.6%); 8.9% of the total number of tests were errors, 0.04% had invalid results and 0.6% ‘no result’. The most frequent error was probe check failure (error 5007). Instrument module A4, B2, B3, C3, and D3 (p<0.05) and tester experience (p<0.05) had a statistically significant association with errors in multivariate analysis. Additional 42 MTB cases (9.2% of the total cases) were detected among unsuccessful results by follow-up tests. Sixty-four percent of the initial test results were released within the turnaround time (TAT) ≤24 hours.ConclusionMost of the quality indicators for the Xpert MTB/RIF molecular assay were maintained within the targets. However, the error rate and TAT were out of the targets. Defective modules and lacking experience were the factors affecting successful test outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Monitoring quality indicators for the Xpert MTB/RIF molecular assay in Ethiopia

et al. 2019

View full text Add to dashboard Cite

show abstract

“…[2,3] A web-based system for GeneXpert reporting, the GxAlert, was introduced in 2012 which facilitates the flow of patients, samples, and results at facility level by transmitting instant SMS results to clinicians and patients. [12,13]…”

Section: Methodsmentioning

confidence: 99%

Rates and timeliness of treatment initiation among drug-resistant tuberculosis patients in Nigeria- A retrospective cohort study

et al. 2019

View full text Add to dashboard Cite

Background There were an estimated 580,000 new cases of multidrug/rifampicin resistant TB (DR-TB) in 2015, and only 20% were initiated on treatment. This study explored health system and patient factors associated with initiation and timeliness of treatment among DR-TB patients in Nigeria, ranked 4 th globally for estimated TB cases in 2015. Methods A retrospective cohort study using 2015 diagnosis and treatment data from the Nigerian TB program electronic records examined “treatment ever received” (yes/no) and “treatment within 30 days” (yes/no). We compared health system and patient characteristics using binomial logistic regression, while controlling for confounders. Results Of 996 patients diagnosed nationwide in 2015 (aged 0–87 years, median 34), 47.8% were never treated. Of those treated (n = 520), 51.2% were treated within the 30 days prescribed in the National treatment guideline. Healthcare facility locations were significantly associated with ever receiving treatment and timely treatment. Predictors of timely treatment at the national level also included level of care and patient treatment history. The South-West zone, where DR-TB programs started, showed overall better access to DR-TB healthcare. Conclusions Healthcare facility geographic locations were significantly associated with treatment initiation and timeliness. Significant regional differences in access to DR-TB care in Nigeria persist, reflecting uneven contexts for national DR-TB treatment rollout.

show abstract

“…Among the studies included in this review, the huband-spoke implementation approach for Xpert was used more often (n=6) 15,[26][27][28][29][30] than the point-of-care model (n=5). [31][32][33][34][35] As part of the hub-and-spoke model, varying approaches to the transportation of samples between the laboratory and clinic were identified, which included transportation by a health care worker, 30 employed drivers, 26,28 and informal couriers. 27 The return of results to the clinic that collected the patient sputum sample most commonly occurred via the same transport network, while a study in Uganda examined the use of SMS to return results directly to the clinic and patient.…”

Section: Implementation Approachesmentioning

confidence: 99%