GeneXpert rollout in three high-burden tuberculosis countries in Africa: A review of pulmonary tuberculosis diagnosis and outcomes from 2001 to 2019
Background: The rollout of GeneXpert aimed at increasing early diagnosis of tuberculosis to improve treatment outcomes and global tuberculosis targets. Objective: This study evaluated trends in tuberculosis diagnosis and outcomes pre- and post-introduction of GeneXpert in three African countries –...
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| Format: | Article |
| Language: | English |
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AOSIS
2022-08-01
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| Series: | African Journal of Laboratory Medicine |
| Subjects: | |
| Online Access: | https://ajlmonline.org/index.php/ajlm/article/view/1811 |
| _version_ | 1818066460869656576 |
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| author | Victor Williams Marianne Calnan Bassey Edem Chukwuemeka Onwuchekwa Chika Okoro Christine Candari Rhodora Cruz Kennedy Otwombe |
| author_facet | Victor Williams Marianne Calnan Bassey Edem Chukwuemeka Onwuchekwa Chika Okoro Christine Candari Rhodora Cruz Kennedy Otwombe |
| author_sort | Victor Williams |
| collection | DOAJ |
| description | Background: The rollout of GeneXpert aimed at increasing early diagnosis of tuberculosis to improve treatment outcomes and global tuberculosis targets.
Objective: This study evaluated trends in tuberculosis diagnosis and outcomes pre- and post-introduction of GeneXpert in three African countries – the Democratic Republic of the Congo (DRC), Nigeria and South Africa.
Methods: Data from 2001 to 2019 were extracted from the World Health Organization’s data repository. Descriptive analysis, paired t-tests and interrupted time series models were used.
Results: Estimated tuberculosis incidence decreased from 327/100 000 to 324/100 000 in the DRC, and from 1220/100 000 to 988/100 000 in South Africa. Incidence remained at 219/100 000 in Nigeria. The tuberculosis case notification rate did not change significantly. Increases in the new case treatment success rates were statistically significant (DRC: p = 0.0201; Nigeria: p = 0.0001; South Africa: p = 0.0017); decreases in mortality were also statistically significant (DRC: p = 0.0264; Nigeria: p = 0.0001; South Africa: p 0.0001). Time series models showed insignificant increases in new tuberculosis cases in DRC (n = 1856, p = 0.085) and Nigeria (n = 785, p = 0.555) from 2011 to 2019; and a statistically significant decrease in South Africa (n = 15 269, p = 0.006).
Conclusion: Improvements in tuberculosis treatment outcomes were achieved, but little progress has been made in new case notification due to varied implementation and scale-up of GeneXpert across the three countries. Implementation barriers need to be addressed to achieve the required tuberculosis targets. |
| first_indexed | 2024-12-10T15:08:09Z |
| format | Article |
| id | doaj.art-a0407ba418364e598cbb578472de59be |
| institution | Directory Open Access Journal |
| issn | 2225-2002 2225-2010 |
| language | English |
| last_indexed | 2024-12-10T15:08:09Z |
| publishDate | 2022-08-01 |
| publisher | AOSIS |
| record_format | Article |
| series | African Journal of Laboratory Medicine |
| spelling | doaj.art-a0407ba418364e598cbb578472de59be2022-12-22T01:44:00ZengAOSISAfrican Journal of Laboratory Medicine2225-20022225-20102022-08-01111e1e810.4102/ajlm.v11i1.1811392GeneXpert rollout in three high-burden tuberculosis countries in Africa: A review of pulmonary tuberculosis diagnosis and outcomes from 2001 to 2019Victor Williams0Marianne Calnan1Bassey Edem2Chukwuemeka Onwuchekwa3Chika Okoro4Christine Candari5Rhodora Cruz6Kennedy Otwombe7Unit of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, JohannesburgUniversity Research Co. LLC, ManilaVaccines and Immunity Theme, MRC Unit the Gambia, London School of Hygiene and Tropical Medicine, FajaraBarcelona Institute of Global Health (ISGlobal), BarcelonaUniversal Health Coverage and Communicable and Non-Communicable Diseases Cluster, World Health Organization, Owerri, Imo StateUniversity Research Co. LLC, ManilaUniversity Research Co. LLC, ManilaUnit of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, JohannesburgBackground: The rollout of GeneXpert aimed at increasing early diagnosis of tuberculosis to improve treatment outcomes and global tuberculosis targets. Objective: This study evaluated trends in tuberculosis diagnosis and outcomes pre- and post-introduction of GeneXpert in three African countries – the Democratic Republic of the Congo (DRC), Nigeria and South Africa. Methods: Data from 2001 to 2019 were extracted from the World Health Organization’s data repository. Descriptive analysis, paired t-tests and interrupted time series models were used. Results: Estimated tuberculosis incidence decreased from 327/100 000 to 324/100 000 in the DRC, and from 1220/100 000 to 988/100 000 in South Africa. Incidence remained at 219/100 000 in Nigeria. The tuberculosis case notification rate did not change significantly. Increases in the new case treatment success rates were statistically significant (DRC: p = 0.0201; Nigeria: p = 0.0001; South Africa: p = 0.0017); decreases in mortality were also statistically significant (DRC: p = 0.0264; Nigeria: p = 0.0001; South Africa: p 0.0001). Time series models showed insignificant increases in new tuberculosis cases in DRC (n = 1856, p = 0.085) and Nigeria (n = 785, p = 0.555) from 2011 to 2019; and a statistically significant decrease in South Africa (n = 15 269, p = 0.006). Conclusion: Improvements in tuberculosis treatment outcomes were achieved, but little progress has been made in new case notification due to varied implementation and scale-up of GeneXpert across the three countries. Implementation barriers need to be addressed to achieve the required tuberculosis targets.https://ajlmonline.org/index.php/ajlm/article/view/1811tuberculosisgenexpertxpert mtb/rifafricainterrupted time series |
| spellingShingle | Victor Williams Marianne Calnan Bassey Edem Chukwuemeka Onwuchekwa Chika Okoro Christine Candari Rhodora Cruz Kennedy Otwombe GeneXpert rollout in three high-burden tuberculosis countries in Africa: A review of pulmonary tuberculosis diagnosis and outcomes from 2001 to 2019 African Journal of Laboratory Medicine tuberculosis genexpert xpert mtb/rif africa interrupted time series |
| title | GeneXpert rollout in three high-burden tuberculosis countries in Africa: A review of pulmonary tuberculosis diagnosis and outcomes from 2001 to 2019 |
| title_full | GeneXpert rollout in three high-burden tuberculosis countries in Africa: A review of pulmonary tuberculosis diagnosis and outcomes from 2001 to 2019 |
| title_fullStr | GeneXpert rollout in three high-burden tuberculosis countries in Africa: A review of pulmonary tuberculosis diagnosis and outcomes from 2001 to 2019 |
| title_full_unstemmed | GeneXpert rollout in three high-burden tuberculosis countries in Africa: A review of pulmonary tuberculosis diagnosis and outcomes from 2001 to 2019 |
| title_short | GeneXpert rollout in three high-burden tuberculosis countries in Africa: A review of pulmonary tuberculosis diagnosis and outcomes from 2001 to 2019 |
| title_sort | genexpert rollout in three high burden tuberculosis countries in africa a review of pulmonary tuberculosis diagnosis and outcomes from 2001 to 2019 |
| topic | tuberculosis genexpert xpert mtb/rif africa interrupted time series |
| url | https://ajlmonline.org/index.php/ajlm/article/view/1811 |
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