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Obsolete TB Diagnostic Machines Miss 60% of Cases in Uganda

Ugandans travel long distances seeking tuberculosis (TB) diagnostic services because most of the lower level health facilities – health centre Is, health centre IIs and health centre IIIs – are equipped, if at all, with obsolete light microscopes used to diagnose PTB by the smear microscopy technique.

The first Uganda national TB Survey that was conducted by Ministry of Health in 2015, moreover, found that “smear microscopy, the main TB diagnostic test in the country, misses about 60% of the cases”; a finding which led the Ministry of Health to conclude that there is a “need to update the country’s TB screening and diagnostic algorithms.”

There are more efficient and more effective technologies, funding permitting, which would be the better option with which to equip Uganda’s lower level health centres.

GeneXpert TB test machines are powerful and highly sensitive molecular diagnostic machines which, for example, according to findings of a study in India (Sreeraj 2015), can detect five times more cases of drug resistant TB.

In Uganda, a country with a high PTB burden, emerging findings from the CPAR investigation indicate an average national ratio of physical presence of GeneXpert machines to the population of 1:353,000.

A CPAR Uganda Ltd qualitative investigation, furthermore, finds that ratios of TB diagnostic machines to the population often go even higher because diagnostic machines often spend long periods of downtime – weeks, months, or even years – during which they do not function.

See table of Uganda GeneXpert TB Testing Machine Coverage submitted here

Photo Credit: Prof. Dr. Christopher G. Orach, CPAR Uganda Ltd Board Chair, delivers a provocation during the policy workshops on TB that were conducted by CPAR Uganda Ltd as part of the qualitative investigation on TB that was conducted by CPAR Uganda Ltd as part of the project: Tuberculosis: Working to Empower the Nation’s Diagnostic Efforts (TWENDE).


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