WoW trucks: revolutionary TB and COVID-19 testing in Nigeria

KNCV Tuberculosis Foundation (KNCV) Nigeria contributes in a revolutionary way to the fight against tuberculosis (TB) and COVID-19. Recently the Wellness on Wheels (WoW) trucks of KNCV Nigeria were equipped to make COVID-19 testing possible, next to the already implemented TB-diagnostics. These mobile health clinics reach people in remote areas, with low access to healthcare.

Nigeria has the highest TB burden in Africa, resulting in about 157,000 TB deaths in 2018 (Global Tuberculosis Report, 2019). This is unnecessary, for with the right treatment and medicines, TB can be cured. KNCV Nigeria has been working with the Nigerian government for four years to stop the TB epidemic. The numbers are falling, and great success is being achieved in the country where HIV and malaria are also common. However, the coronavirus creates an even bigger and new health challenge. KNCV does everything it can to assist the Nigerian government and the Nigerian people to fight both TB and COVID-19.

WoW trucks: diagnostics and referral

The WoW trucks were procured with USAID funding by KNCV Nigeria for mobile TB case finding targeting TB hot spots and hard to reach locations. The trucks have been used by KNCV Nigeria since 2018 and most recently in the TB LON Regions 1 & 2 project in partnership with WHO and the National TB Program. Presumptive TB patients are screened through the use of CAD4TB software that digitally assesses X-rays. Their sputum sample is examined with a GeneXpert machine. Testing for COVID-19 is now also integrated, using the same machine.

The two trucks can each test around 100 people per day for both infectious diseases.

“WoW trucks as mobile testing platforms have the advantage of moving to remote locations taking diagnosis to the doorstep of the patients. Prior to community screening, advocacy is conducted in the Local Government Area and the community is engaged to ensure proper awareness creation and mobilization for the screening”, says Mustapha Tukur the KNCV Nigeria ACF (Active Case Finding) coordinator Northern WoW-truck.

Fight against TB and COVID-19

Since 2014, Cepheid – the company that produces GeneXpert machines – has appointed KNCV as Authorized Service Provider for the use of GeneXpert in Nigeria. A total of 413 GeneXpert machines are now used in the fight against TB and COVID-19. With 396 machines for TB while 17 machines are used for COVID-19.
For people in remote areas however, healthcare centers with this testing capacity are often hard to reach. Where in many countries ‘drive thru’ testing centers are being set up to make testing more accessible, in Nigeria the WoW trucks literally bring the tests to the people.

Mobile diagnostics

Since the first COVID-19 tests were performed in the WoW trucks on the 11th of June 2020, 12 patients were diagnosed with TB and all have been placed on treatment. A total of 256 positive COVID-19 patients have been found and moved to the isolation centers in the state for treatment. None of them tested positive for both diseases.

In Nigeria, over 57,000 COVID-19 infections have been counted so far and according to official counts from the Nigeria Center for Disease Control, over 1,000 people have died from the coronavirus. In reality, there are probably many more, because the test capacity in the largest country in Africa is very limited.

Nigeria is not the only country where more testing capacity is much needed. KNCV has contributed to projects with similar mobile diagnostic trucks in Swaziland, Romania, Zambia, Zimbabwe and Malawi and is looking at the possibilities of scaling up the intervention in more countries.

READ MORE: Behind the mask, working on the WoW truck

KNCV has been fighting TB since its establishment in 1903. Over the past 117 years, the organization has acquired indispensable knowledge and experience in the field of effective TB control, resulting in pre-elimination in the Netherlands and significant contributions to global evidence generation, policy development and TB program implementation worldwide.

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Tuberculosis is still one of the major causes of preventable death in the world and claims over 4000 lives a day, leading to over 1,5 million deaths a year.

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