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Countrywide roll-out of Xpert® MTB/RIF in Swaziland: the first three years of implementation | Journal Article / Research | MSF Science Portal
Journal Article
|Research

Countrywide roll-out of Xpert® MTB/RIF in Swaziland: the first three years of implementation

Sikhondze W, Dlamini T, Khumalo D, Maphalala G, Dlamini SV, Zikalala T, Albert H, Wambugu J, Tayler-Smith K, Ali E, Ade S, Harries AD
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Abstract
SETTING
All 19 public health laboratories in Swaziland that had Xpert(®) MTB/RIF machines installed as part of a countrywide roll-out between June 2011 and June 2014.

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.

Countries

Eswatini

Subject Area

antibiotic resistancetuberculosisSORT-ITantimicrobial resistance

Languages

English
DOI
10.5588/pha.15.0001
Published Date
21 Jun 2015
PubMed ID
26400386
Journal
Public Health Action
Volume | Issue | Pages
Volume 5, Issue 2, Pages 140-146
Issue Date
2015-06-21
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