The Xpert MTB/RIF diagnostic test has tremendous potential for improving tuberculosis (TB) diagnostic capacity in countries with a high burden of TB. The use of this rapid diagnostic test has spread widely across the globe since Xpert MTB/RIF was endorsed by the World Health Organization (WHO) for roll out in 2010.
However, in some cases countries are facing operational difficulties, and the performance of the diagnostic tool is not always optimal. KNCV Tuberculosis Foundation is therefore supporting countries with the implementation and scale-up of Xpert MTB/RIF.
KNCV has directly supported the rollout of this diagnostic tool in at least ten countries. One of these countries is Nigeria.
Rollout of GeneXpert in Nigeria
Under the auspices of the National AIDS Control Agency (NACA) in Nigeria, KNCV is leading a team to build an Xpert MTB/RIF network that is supported by the Global Fund. The aim of the network is to comprehensively strengthen the detection of TB among people living with HIV.
We are also successfully running a pilot project for service provision of the GeneXpert machine in partnership with Cepheid HBDC. This service provision started in the third quarter of 2014, using a stepwise approach.
The aim of this activity is to reduce machine down-time to a minimum. This is done by ensuring well-trained maintenance of GeneXpert instruments, and making sure that there is a database of people who are trained in troubleshooting, machine calibrations, installation and problem-solving, either on-site or remote. KNCV supervises the one-day installation and training for new GeneXpert end users.
By mid-2015, 164 GeneXpert instruments were being serviced in this way. Twelve new GeneXpert instruments had been installed, 34 instruments had undergone their annual calibration, 59 sites had received maintenance support, and successful troubleshooting had taken place at 107 sites.
We have also developed standard operating procedures for communication with the laboratories, hospitals, health centers (customers) using the GeneXpert instruments. Toll-free numbers for support were established for customers to call free-of-charge, and databases for the monitoring of maintenance and troubleshooting were set up. We helped to strengthen the National TB and Leprosy Control Program’s coordination with partners using GeneXpert. As a result, the performance of the tools has improved, with less downtime of instruments awaiting maintenance or calibration, and a pool of superusers is now actively engaged to further support these processes.
KNCV is continuing to support the GeneXpert service provision in Nigeria as well as in Vietnam, and is working to establish similar projects in Tajikistan and Uzbekistan, in close collaboration with Cepheid HBDC.