Last modified: 2023-02-23
Abstract
EVALUATION OF GENEXPERT MYCOBACTERIUM
TUBERCULOSIS/RIFAMPICIN ASSAY IMPLEMENTATION IN SNNPRS, ETHIOPIA, 2022; - A METHOD RETROSPECTIVE STUDY DESIGN
Temesgen Kelaye1, Mamush Hussen2, Endashaw Shibru3, Fisha Lamango1, Mintasinote Malka2, Girmma Wondimu4, Zeneba Tamami4, Tebeje Misganaw1, Biruk G/madihione1
1 Health Research and Technology Transfer Directorate, SNNPR Health Bureau, Hawassa, Sidama, Ethiopia. 2 Public Health Institute General Director Office, SNNPR Health Bureau, Hawassa, Sidama, Ethiopia. 3 SNNPR Health Bureau Head office, Hawassa, Sidama, Ethiopia. 4 Regional laboratory Directorate, SNNPR Health Bureau, Hawassa, Sidama, Ethiopia,
Background: GeneXpert Mycobacterium tuberculosis/Rifampicin (GeneXpert MTB/RIF) Assay diagnostic technology is simple and safe, fast and has the advantage of detecting resistance to rifampicin. Although GeneXpert MTB/RIF Assay access is increasing, its performance was not assessed regionally. So, this study was designed to assess performance of GeneXpert MTB/RIF Assay implementation in the South Nations Nationalities and People Regional State 2022
Methods: Cross-sectional study design was used to review records retrospectively in 29 GeneXpert sites in SNNPRS. The study included GeneXpert data from January 2021-December 2022 year. A sample size of 27222 was used. All records that fulfilled the inclusion criteria were included in this study. Structured checklist was prepared, pretested and uploaded to the KoBoToolbox data collection system. Data was reviewed by lab experts who have experience of running the machine. Excel file from KoBoToolbox was imported to SPSS 25 for analysis. Descriptive statistics and binary logistic regression model were used.
Result: - In this study the yield of MTB detection rate was found to be 4321(16 %). Out of 4321 MTB positive cases 75(1.8%), had Rif resistance and 45 (1.1%) were MTB detected Rif indeterminate. The utilization rate of Gene Xpert MTB/RIF assay was found to be, 35%. The unsuccessful test result was found to be 2972 (11%). Of this, the error rate was 1470 (5.4%), no result was 1348(5%) and invalid results were 154(0.56 %) reported. Independent predictors of MTB detection rate identified by the multivariate logistic analysis were being sex of male {AOR, 5.21,95% CI; [ 4.91,5.861}] was found to be significantly associated with the MTB detection rate.
Conclusion: - Detection rate of Tuberculosis with the Gene Xpert MTB/RIF assay and a utilization rate was low. This might be due to the inappropriate eligibility screening and nonfunctional module available. Low utilization rate and RIF resistance were observed as compared to WHO standard. Being sex of male was significantly associated with MTB detection. Error rate and no result were high as comparing with the expected standard (≤3%). However, better to increase the detection rate of MTB, improving the utilization rate of GeneXpert MTB/RIF Assay, male gender targeted awareness creation, improving poor registration, accurate sampling eligible for diagnosis, reduce error rate, no result and invalid results by minimizing technical error, proper temperature control, preventing power failure and cleaning environmental dusting and fan filter. Keywords: - MTB, GeneXpert utilization rate, Rifampicene resistance, error rate, unsuccessful text result, GeneXpert public health facility, SNNPRS