08 Jan Institute of Human Virology Nigeria (IHVN) raises awareness about GeneXpert technology to improve TB case finding
[vc_row css_animation=”” row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” angled_section=”no” text_align=”left” background_image_as_pattern=”without_pattern”][vc_column][vc_separator type=”normal” thickness=”2″ up=”20″ down=”20″][/vc_column][/vc_row][vc_row css_animation=”” row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” angled_section=”no” text_align=”left” background_image_as_pattern=”without_pattern”][vc_column][vc_gallery type=”nivo” interval=”3″ images=”2423,2422″ img_size=”full”][vc_column_text]Since 2013, the World Health Organization (WHO) recommends the use of Xpert/MTB Rif assay over smear microscopy as an initial TB diagnostic tool. Although this recommendation dates back more than 5 years, the Institute of Human Virology in Nigeria (IHVN) found that there is still a lack of awareness among health care providers about the availability and significantly high diagnostic accuracy of Xpert/MTB Rif assay. This contributes to sub-optimal utilization of the technology and ongoing low TB case finding in the country.
To improve awareness and generate more demand for the use of GeneXpert tests, IHVN conducted 1-day sensitization exercises for different cadres of health workers across primary, secondary and tertiary health care facilities in the States of Lagos, Osun, Oyo, Kaduna and Kano. A hub and spoke model was used for these exercises where 5 contiguous primary health care centers were brought together at a central location or hub (usually a secondary or tertiary health facility with available GeneXpert technology). The subjects addressed revolved around TB/DR-TB epidemiology, trends in TB case finding, diagnostic algorithms, Xpert technology and TB infection control. Additionally, assessments of sputum transport modalities and mapping of Xpert sites were carried out.
The intervention was conducted in 30 sites in 5 States of Nigeria. A review of the national laboratory test output was used to identify 30 GeneXpert facilities with low number of tests per quarter across 5 priority states: Lagos, Osun, Oyo, Kaduna and Kano. These served as hub facilities for the exercises. The participating health care providers included doctors, nurses, laboratory scientists, DOTS providers and local government TB supervisors.
Thanks to the sensitization exercises, there was an increased awareness amongst health care providers, who educated patients and surrounding communities on TB. This led to an increased demand for GeneXpert tests, with resultant need for all TB stakeholders in the country to provide necessary optimization support for the technology.
In Q3 2018, sputum samples received and tested at 30 GeneXpert sites post-sensitization increased by 21% and 25% respectively and TB cases diagnosed increased by 15% compared to Q2 2018.
Improving access
Road conditions in Nigeria are difficult due to harsh geographical terrains, bad weather and long distances. This hinders prompt testing as it makes it hard to deliver sputum samples to the facilities were GeneXpert machines are situated. To address this issue, trained sputum transporters and motorcycle riders are engaged to move samples from spoke facilities to hubs for TB testing.
Moreover, machines were not able to function properly due to irregular electricity supply at many GeneXpert sites. To keep a stable power flow, solar panels and inverters were provided to high workload testing sites across all 36 states and the Federal Capital Territory. GeneXpert facilities with inadequate storage equipment in the laboratory also received solar refrigerators.
In the coming months, IHVN will focus on consolidating the gains of this intervention by sensitizing larger audiences on GeneXpert technology at different forums such as Continuous Medical Education (CME) seminars and Annual Scientific Conferences of health professional bodies.[/vc_column_text][/vc_column][/vc_row]