Scale-up and impact of digital and molecular diagnostic technologies on TB diagnosis and timely linkage to care in Tajikistan
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 quali...
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The Journal of Infection in Developing Countries
2021-09-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/13758 |
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| author | Shodmon Khushvakhtov Hayk Davtyan Sevak Alaverdyan Anthony D Harries Olim Kabirov Shahnoza Azamova Firuza Sharipova Safarkhon Sattorov Asliddin Rajabov |
| author_facet | Shodmon Khushvakhtov Hayk Davtyan Sevak Alaverdyan Anthony D Harries Olim Kabirov Shahnoza Azamova Firuza Sharipova Safarkhon Sattorov Asliddin Rajabov |
| author_sort | Shodmon Khushvakhtov |
| collection | DOAJ |
| description |
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.
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| format | Article |
| id | doaj-art-e7b9fec7333b4e8ca4e9629c10ab49bf |
| institution | OA Journals |
| issn | 1972-2680 |
| language | English |
| publishDate | 2021-09-01 |
| publisher | The Journal of Infection in Developing Countries |
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| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-e7b9fec7333b4e8ca4e9629c10ab49bf2025-08-20T02:14:20ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802021-09-011509.110.3855/jidc.13758Scale-up and impact of digital and molecular diagnostic technologies on TB diagnosis and timely linkage to care in TajikistanShodmon Khushvakhtov0Hayk Davtyan1Sevak Alaverdyan2Anthony D Harries3Olim Kabirov4Shahnoza Azamova5Firuza Sharipova6Safarkhon Sattorov7Asliddin Rajabov8Republican Center for Protection of Population from TB, Dushanbe, Republic of TajikistanTuberculosis Research and Prevention Center, Yerevan, ArmeniaTuberculosis Research and Prevention Center, Yerevan, ArmeniaInternational Union against Tuberculosis and Lung Disease, Paris, FranceNational Reference Laboratory on the basis of National Tuberculosis Hospital Machiton, Republic of TajikistanRepublican Center for Protection of Population from TB, Dushanbe, Republic of TajikistanRepublican Center for Protection of Population from TB, Dushanbe, Republic of TajikistanMinistry of Health and Social Protection of Population of the Republic of TajikistanRepublican Center for Protection of Population from TB, Dushanbe, Republic of Tajikistan 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. https://jidc.org/index.php/journal/article/view/13758Drug-resistant tuberculosisTajikistanGeneXpertGxAlertdiagnosis and linkage to careOpen |
| spellingShingle | Shodmon Khushvakhtov Hayk Davtyan Sevak Alaverdyan Anthony D Harries Olim Kabirov Shahnoza Azamova Firuza Sharipova Safarkhon Sattorov Asliddin Rajabov Scale-up and impact of digital and molecular diagnostic technologies on TB diagnosis and timely linkage to care in Tajikistan Journal of Infection in Developing Countries Drug-resistant tuberculosis Tajikistan GeneXpert GxAlert diagnosis and linkage to care Open |
| title | Scale-up and impact of digital and molecular diagnostic technologies on TB diagnosis and timely linkage to care in Tajikistan |
| title_full | Scale-up and impact of digital and molecular diagnostic technologies on TB diagnosis and timely linkage to care in Tajikistan |
| title_fullStr | Scale-up and impact of digital and molecular diagnostic technologies on TB diagnosis and timely linkage to care in Tajikistan |
| title_full_unstemmed | Scale-up and impact of digital and molecular diagnostic technologies on TB diagnosis and timely linkage to care in Tajikistan |
| title_short | Scale-up and impact of digital and molecular diagnostic technologies on TB diagnosis and timely linkage to care in Tajikistan |
| title_sort | scale up and impact of digital and molecular diagnostic technologies on tb diagnosis and timely linkage to care in tajikistan |
| topic | Drug-resistant tuberculosis Tajikistan GeneXpert GxAlert diagnosis and linkage to care Open |
| url | https://jidc.org/index.php/journal/article/view/13758 |
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