Unsuccessful Xpert MTB/RIF Results: the Nigerian Experience

Overview

Journal Public Health Action

Date 2018 Mar 28

PMID 29581936

Citations 17

Authors

M Gidado

N Nwokoye

P Nwadike

P Ajiboye

R Eneogu

S Useni

J Onazi

A Lawanson

E Elom

A Tubi

J Kuye

Affiliations

Soon will be listed here.

Abstract

Nigeria, a high tuberculosis (TB) burden country. To study the rate, distribution and causes of unsuccessful Xpert MTB/RIF test outcomes, with the aim of identifying key areas that need to be strengthened for optimal performance of the assay. This was a retrospective analysis of data uploaded between January and December 2015 from Xpert facilities to the central server using GXAlert. Of 52 219 test results uploaded from 176 Xpert machines, 22.5% were positive for Mycobacterium tuberculosis, 10.8% of which were rifampicin-resistant; 4.7% of the total number of results were invalid, 4.2% had error results and 2.1% no result outcomes. Technical errors were most frequent (69%); these were non-seasonal and occurred in all geopolitical regions and at all health facility levels. Temperature-related errors were more prevalent in the North-West Region, with peaks in April to June. Peak periods for temperature and machine malfunction errors coincided with the periods of low utilisation of the assay. The key challenge affecting performance was poor adherence to standard operating procedures. Periodic refresher training courses, regular supervision, preventive maintenance of Xpert machines and proper storage of cartridges are strategies that could improve Xpert performance.

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