ASLM Co-Sponsors Training Workshop on Pioneering Rapid TB Diagnostic Technology

ASLM co-sponsored the second African regional training workshop on the Cepheid Xpert MTB/RIF from 23-25 July in Gaborone, Botswana. Cepheid Xpert MTB/RIF is an auto-mated diagnostic test for detecting Mycobacterium tuberculosis and resistance to rifampicin, an antibiotic used to treat tuberculosis (TB). The US Government, in partnership with TB CARE I (KNCV Tuberculosis Foundation) and ASLM, convened public health officials, clinical experts and laboratory personnel with the purpose of assisting participating African countries in the roll-out of Xpert MTB/RIF, particularly for the diagnosis of TB in HIV-infected individuals.

People living with HIV are up to 50 times more likely to contract TB than HIV-uninfected people.[1] Delayed TB diagnosis is common among individuals co-infected with HIV/TB, who are more likely to have smear-negative pulmonary TB.[2]  Consequently, HIV-related TB deaths pose a major public health concern in settings where HIV is widespread. The Xpert MTB/RIF test has greater sensitivity than spu-tum smear microscopy, especially in cases of HIV/TB co-infection.[3]

During the workshop, ASLM leaders presented the Society’s expected role in the TBXpert Project, a new collaborative programme from the World Health Organization and UNITAID. Between 2013 and 2015, the TBXpert Project will distribute approximately 1.4 million Xpert MTB/RIF test cartridges and over 220 GeneXpert instruments in 21 recipient countries.[4] ASLM’s role is to collaborate with national and sub-regional partners to ensure optimal use of Xpert MTB/RIF in African national TB control programmes (NTPs) as well as to help monitor project progress. The Society will support Xpert MTB/RIF implementation in Ethiopia, Kenya, Mozambique, Republic of Con-go and Tanzania. ASLM-specific activities in project countries will include:

• coordinating on-site mentoring of NTP staff and partners to ensure correct use of TBXpert products;
• co-organising training workshops on the optimal use of Xpert MTB/RIF in country-specific epidemiological settings;
• facilitating the documentation and reporting of site-specific data on project progress and impact indicators;
• monitoring supply chains to facilitate accurate forecasting of TBXpert product requirements;
• facilitating importation procedures as needed;
• leveraging existing capacity and SLIPTA activities to help NTPs and their partners incorporate Xpert MTB/RIF into national laboratory policies.

Since 2010, WHO has recommended Xpert MTB/RIF as a primary diagnostic test for the rapid and simultaneous detection of TB and rifampicin resistance.[5] The test can be performed outside of centralised reference laboratories provided that sufficient infrastructure and trained staff are available.[6] By scaling up implementation of Xpert MTB/RIF TB in participating African countries, the TBXpert Project has the potential to drastically accelerate and improve detection and treatment rates for TB and multi-drug-resistant TB. Through its involvement in the TBXpert Project, ASLM will help pro-mote capacity to provide accurate disease diagnosis, monitoring and treatment in the African region.

The Xpert MTB/RIF workshop provided opportunities for participants to better understand the practical aspects of Xpert MTB/RIF implementation and develop their national Xpert MTB/RIF scale-up plans. The workshop also increased aware-ness of latest global policy guidance on Xpert MTB/RIF and allowed participants to exchange experiences regarding Xpert MTB/RIF implementation, including challenges and lessons learned.

For more information on Xpert MTB/RIF, please visit: http://www.who.int/tb/laboratory/mtbrifrollout/en/index.html.