Countrywide roll-out of Xpert® MTB/RIF in Swaziland: the first three years of implementation
Objective: To evaluate the utilisation and functionality of Xpert from 2011 to mid-2014.
Design: Descriptive study of Xpert implementation using routinely collected data.
Results: Of 48 829 Xpert tests conducted, 93% were successful: 14% detected Mycobacterium tuberculosis and 12% showed rifampicin resistance. The most common cause of unsuccessful tests was an ‘Error’ result (62%). Similar findings were obtained in government-supported and partner-supported laboratories. Annual utilisation of Xpert improved from 51% of maximum capacity in 2011 and 2012 to 74% in 2013 and 2014. A monitoring and supervision exercise of all Xpert testing sites in 2014 showed a generally good performance, with over 50% of laboratories achieving a 80% score on most components. However, poor scores were obtained with equipment use and maintenance (6% achieving a score of 80%), internal audit (19% achieving a score of 80%) and process control (25% achieving a score of 80%).
Conclusion: Countrywide roll-out of Xpert in Swaziland has been successful, although operational issues have been identified and need to be resolved.
Keywords: SORT IT; Swaziland; Xpert® MTB/RIF; operational research; tuberculosis
Document Type: Research Article
Affiliations: 1: National Tuberculosis Control Programme, Mbabane, Swaziland, Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland 2: National Tuberculosis Control Programme, Mbabane, Swaziland 3: National Tuberculosis Control Programme, Mbabane, Swaziland, National TB Reference Laboratory, Mbabane, Swaziland 4: Swaziland Health Laboratory Services, Mbabane, Swaziland 5: National TB Reference Laboratory, Mbabane, Swaziland, University Research Co., Center for Human Services, Mbabane, Swaziland 6: Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland 7: Médecins Sans Frontières, Medical Department, Operational Research Centre, Brussels, MSF-Luxembourg, Luxembourg 8: National Tuberculosis Programme, Cotonou, Bénin, International Union Against Tuberculosis and Lung Disease, Paris, France 9: International Union Against Tuberculosis and Lung Disease, Paris, France, London School of Hygiene & Tropical Medicine, London, United Kingdom
Publication date: 21 June 2015
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