Scale-up and impact of digital and molecular diagnostic technologies on TB diagnosis and timely linkage to care in Tajikistan

  • Shodmon Khushvakhtov Republican Center for Protection of Population from TB, Dushanbe, Republic of Tajikistan
  • Hayk Davtyan Tuberculosis Research and Prevention Center, Yerevan, Armenia
  • Sevak Alaverdyan Tuberculosis Research and Prevention Center, Yerevan, Armenia
  • Anthony Harries International Union against Tuberculosis and Lung Disease, Paris, France
  • Olim Kabirov National Reference Laboratory on the basis of National Tuberculosis Hospital Machiton, Republic of Tajikistan
  • Shahnoza Azamova Republican Center for Protection of Population from TB, Dushanbe, Republic of Tajikistan
  • Firuza Sharipova Republican Center for Protection of Population from TB, Dushanbe, Republic of Tajikistan
  • Safarkhon Sattorov Ministry of Health and Social Protection of Population of the Republic of Tajikistan
  • Asliddin Rajabov Republican Center for Protection of Population from TB, Dushanbe, Republic of Tajikistan
Keywords: Drug-resistant tuberculosis, Tajikistan, GeneXpert, GxAlert, diagnosis and linkage to care, Open, SORT IT

Abstract

Introduction: Tajikistan is scaling up molecular diagnostic and digital technologies to strengthen its fight against drug-resistant TB (DR-TB). The study aimed to document national scale-up GeneXpert/GxAlert and Open MRS from 2012-2019 and compare time taken from TB diagnosis to treatment and quality of data recording before and after the introduction of GxAlert.

Methodology: This was a longitudinal study that included a comparison of historical cohorts. Continuous variables were compared using Wilcoxon Rank-Sum test and categorical variables using the chi square test.

Results: GeneXpert was introduced in 2011 and scaled up to 46 instruments in 43 (51%) diagnostic laboratories by May 2019. GxAlert was introduced in August 2018 and connected with all GeneXpert instruments by February 2019. Open MRS was introduced in 2014 and implemented in all 108 treatment centers by mid-2018. Time from diagnosis to treatment pre-GxAlert (range 0-749, median 3, days) was significantly longer than with GxAlert (range 0-273, median 3, days) (p <0.001). The proportion of patients whose time from diagnosis to treatment was > 2 weeks was 16% (282/1740) pre-GxAlert and 11% (206/1902) with GxAlert (p < 0.001). Between 31%-34% of patients with DR-TB results in Open MRS did not have results available in GeneXpert/GxAlert systems. Where results were present in both systems, there were discrepancies in 8.2% of patients pre-GxAlert and 4.3% with GxAlert (p = 0.25).

Conclusions: The scale-up of GeneXpert and digital technologies in Tajikistan was associated with a reduction in the proportion of patients with delays more than 2 weeks between diagnosis and treatment, but data quality recording improved only slightly.

Published
2021-09-29
How to Cite
1.
Khushvakhtov S, Davtyan H, Alaverdyan S, Harries A, Kabirov O, Azamova S, Sharipova F, Sattorov S, Rajabov A (2021) Scale-up and impact of digital and molecular diagnostic technologies on TB diagnosis and timely linkage to care in Tajikistan. J Infect Dev Ctries 15:58S-65S. doi: 10.3855/jidc.13758
Section
EECA Regional SORT IT