Effects of Xpert<sup>®</sup> MTB/RIF testing and GxAlert on MDR-TB diagnosis and linkage to care in Mozambique

Beste, Jason; Mutaquiha, Cláudia; Manhiça, Ivan; Jose, Beena Philomina; Monivo, C.; Faria, Marina Neves Zerbini de; Creswell, Jacob; Codlin, Andrew James; Michel, Cathy; Wagenaar, Bradley H.; Gloyd, Stephen; Cowan, James

doi:10.5588/ijtld.17.0901

Cited by 7 publications

(9 citation statements)

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“…Several eHealth definitions have been adopted by researchers, academic institutions, professional bodies and funding organisations. eHealth is making headway in the treatment of mental disorders, 10,11 self-health monitoring, 12 disease diagnosis, 13 physical activity intervention for the medically challenged and survivors, 14,15 and many other health-related scenarios. With regards to the definition of eHealth, researchers have found it difficult to reach a consensus.…”

Section: Literature Reviewmentioning

confidence: 99%

Factors influencing adoption of eHealth technologies in Ghana

2019

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This study covers factors influencing the adoption of electronic health (eHealth) technologies in Ghana. The study was designed as a quantitative survey with questionnaire as the main method of data gathering. A total of 1640 questionnaires were administered to users and potential users of eHealth technologies in both public and private healthcare centres in Ghana. The study concludes that institutional characteristics and healthcare manager characteristics have a high influence on eHealth adoption. However, factors related to performance expectancy and effort expectancy only have low influence on the adoption of eHealth devices and systems. Accordingly, the study makes recommendations to policymakers for improving eHealth adoption in the health sector.

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Section: Literature Reviewmentioning

confidence: 99%

Factors influencing adoption of eHealth technologies in Ghana

2019

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“…There is also a gap between the number of people diagnosed with and the number of people notified with TB-this is referred to as pre-treatment lost to follow-up (PTFLU). [10][11][12][13][14] We hypothesized the following situations occurred in the districts where we worked: 1) a number of individuals with TB who present to health facilities are not diagnosed; 2) TB contact tracing could be optimized if Community Health Workers (CHWs) were given a role in it; 3) CHWs could identify individuals that are PTLTFU (people who are tested and have a positive laboratory test for TB, but are not subsequently informed of their results and do not begin treatment for TB) and 4) CHWs can help relink individuals that stop their anti-TB therapy or are lost to follow-up (LTFU) to care. We wanted to evaluate if interventions performed by CHWs to improve all these four weaknesses could lead to an increase in TB notifications at the district level.…”

Section: Introductionmentioning

confidence: 99%

“…Multiple studies have documented significant individual patient and health system delays in TB diagnosis in Mozambique. [ 10 , 11 ] People with TB often experience barriers to access the health facilities, first seek care from traditional healers, and/or visit health facilities several times before being tested and diagnosed with TB. This may partly explaining the gap between the actual number of people diagnosed and notified by the health system and the estimated number of people with TB in Mozambique.…”

Section: Introductionmentioning

confidence: 99%

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Using community health workers for facility and community based TB case finding: An evaluation in central Mozambique

et al. 2020

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Background Mozambique has one of the highest incidence rates of both TB and HIV in the world and an estimated tuberculosis (TB) treatment coverage of only 57% in 2018. Numerous approaches are being tested to reduce existing gaps in coverage and the estimated number of missing cases. Methods Thirty Community Healthcare Workers (CHWs) were tasked with increasing TB notifications by performing verbal facility-based TB screening of all people presenting for care and TB contact tracing in the community. Using routine National TB Program data, we analyzed trends in TB notifications in five intervention districts and seven control districts in Manica province the year before this project and during a one-year intervention period. Results In the four quarters before the study, the intervention districts notified 5,219 individuals with all forms of TB, and the control districts notified 2,248 TB cases. During the study 5,982 all forms of people with TB were notified in the intervention area, an increase of 763 (14.6%) over the baseline, whereas the control districts notified 1,877 persons with TB, a decrease of-371 (-16.5%). The CHW screening activities yielded 1,502 notified and treated individuals with TB. Conclusions Employing CHWs to promote facility-based TB screening and household contact tracing may lead to an overall increase in TB notification.

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“…Third, we need to conduct an individual cascade of care to determine whether patients with laboratory-confirmed MDR-TB and XDR-TB start treatment and in a timely way. A digital platform (GxAlert) is now available electronically and in real-time to connect GeneXpert instruments and assay results with clinics, doctors and patients [ 40 , 41 ]. This is already being piloted in Uzbekistan to see whether it improves linkage of diagnosis to care.…”

Section: Discussionmentioning

confidence: 99%

Scaling Up Molecular Diagnostic Tests for Drug-Resistant Tuberculosis in Uzbekistan from 2012–2019: Are We on the Right Track?

Yuldashev

Parpieva

Alimov

et al. 2021

IJERPH

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Uzbekistan has a large burden of drug-resistant tuberculosis (TB). To deal with this public health threat, the National TB Program introduced rapid molecular diagnostic tests such as Xpert MTB/RIF (Xpert) and line probe assays (LPAs) for first-line and second-line drugs. We documented the scale-up of Xpert and LPAs from 2012–2019 and assessed whether this led to an increase in patients with laboratory-confirmed multidrug-resistant/rifampicin-resistant TB (MDR/RR-TB) and extensively drug-resistant TB (XDR-TB). This was a descriptive study using secondary program data. The numbers of GeneXpert instruments cumulatively increased from six to sixty-seven, resulting in annual assays increasing from 5574 to 107,330. A broader use of the technology resulted in a lower proportion of tests detecting Mycobacterium tuberculosis with half of the positive results showing rifampicin resistance. LPA instruments cumulatively increased from two to thirteen; the annual first-line assays for MDR-TB increased from 2582 to 6607 while second-line assays increased from 1435 in 2016 to 6815 in 2019 with about one quarter to one third of diagnosed patients showing second-line drug resistance. Patient numbers with laboratory-confirmed MDR-TB remained stable (from 1728 to 2060) but there was a large increase in patients with laboratory-confirmed XDR-TB (from 31 to 696). Programmatic implications and ways forward are discussed.

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Effects of Xpert^® MTB/RIF testing and GxAlert on MDR-TB diagnosis and linkage to care in Mozambique

Cited by 7 publications

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Factors influencing adoption of eHealth technologies in Ghana

Factors influencing adoption of eHealth technologies in Ghana

Using community health workers for facility and community based TB case finding: An evaluation in central Mozambique

Scaling Up Molecular Diagnostic Tests for Drug-Resistant Tuberculosis in Uzbekistan from 2012–2019: Are We on the Right Track?

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Effects of Xpert® MTB/RIF testing and GxAlert on MDR-TB diagnosis and linkage to care in Mozambique

Cited by 7 publications

References 0 publications

Factors influencing adoption of eHealth technologies in Ghana

Factors influencing adoption of eHealth technologies in Ghana

Using community health workers for facility and community based TB case finding: An evaluation in central Mozambique

Scaling Up Molecular Diagnostic Tests for Drug-Resistant Tuberculosis in Uzbekistan from 2012–2019: Are We on the Right Track?

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Effects of Xpert^® MTB/RIF testing and GxAlert on MDR-TB diagnosis and linkage to care in Mozambique