Diagnosing and Treating Drug-Resistant Tuberculosis
HAI spearheaded the creation of a unified national database to track drug resistant tuberculosis (DR-TB) across Mozambique and help link patients to treatment.
In Mozambique, HAI worked in partnership with the National Tuberculosis Program to build a unified national database of tuberculosis drug resistance in Mozambique. In addition to equipping the health system with additional TB detection equipment (LED microscopy) HAI piloted the use of a DNA-based test that also tests for drug resistance (GeneXpert). Since the successful pilot, GeneXpert use has been scaled nationally in Mozambique.
HAI also piloted and scaled up a real-time electronic results and reporting platform called GxAlert—which produces routine clinical reports for use by provincial TB and DR-TB supervisors throughout the country—and tied it to the National Tuberculosis Laboratory Information System to ensure that patients in their respective provinces are getting into treatment.
These efforts have helped to improve standardized reporting of known TB cases, and reduce the large pre-treatment lost to follow-up gap between patients diagnosed with DR-TB and those started on treatment.
HAI-LIGHTS
HAI in partnership with the Mozambican NTP piloted the use of a novel molecular or DNA based test for TB that also tested for drug-resistance called GeneXpert. GeneXpert has since been scaled nationally, and now accounts for over 80% of all patients diagnosed and treated with DR-TB
Following the rapid scale-up of GxAlert, with the ability to capture over 90% of all GeneXpert test results in the National unified DR-TB database, linkage to care for RR-TB patients diagnosed by Xpert increased from ~50% in 2012-2015 to 87-90% in 2018.
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Publications
| Barriers to access and adherence to tuberculosis services, as perceived by patients: A qualitative study in Mozambique. | PLoS One, 2019 |
| Spatial epidemiology for tuberculosis surveillance: a relevant add-on to routine surveillance. | Int J Tuberc Lung Dis, 2019 |
| Effects of Xpert MTB/RIF testing and GxAlert on MDR-TB diagnosis and linkage to care in Mozambique | Int J Tuberc Lung Dis, 2018 |
| Tuberculosis in Mozambique: Where do we Stand? | Curr Trop Med Rep, 2018 |
| Remote monitoring of Xpert® MTB/RIF testing in Mozambique: results of programmatic implementation of GxAlert. | Int J Tuberc Lung Dis, 2016 |
| Implementing rapid testing for tuberculosis in Mozambique. | Bull World Health Org, 2014 |
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Funding
[2018-2020] Optimizing the safety of drug resistant-TB treatment with mobile audiometry and ECG testing to prevent complications.
This project received funding support from the Stop TB Partnership.
[2017-2018] Improving Diagnostic, Linkage to Care, and Routing Reporting for TB, MDR/RR-TB and XDR-TB Patients in Mozambique.
This project received funding support from the Stop TB Partnership.
[2014-2016] Strengthening the Tuberculsis Care Cascade in Central and Southern Mozambique.
This project received funding support from the Stop TB Partnership.
[2011-2014] Increasing access to sensitive and rapid TB diagnostics (GeneXpert) to improve TB diagnosis in Sofala and Manica Provinces, Mozambique.
This project received funding support from the Stop TB Partnership.
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