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- Title
A qualitative study on health facility utilization of GeneXpert machines for TB diagnosis in Tanzania.
- Authors
Pamba, Doreen
- Abstract
Background: Tanzania with approximately 295 TB cases per 100,000 populations is among the 30 WHO identified high TB burden countries in the world. According to TB program review report of 2020, there was a decline of bacteriologically confirmed cases between 2015 and 2019 from 42% to 35% despite a significant country level investment in GeneXpert MTB/RIF machines from to 95 to 238 in 2019. Objective: To assess factors influencing utilization of the distributed GeneXpert machines in diagnostic centers. Methods: A qualitative descriptive study using structured interviews was conducted between November and December 2020. Fourteen health facilities in six regions were purposively selected while clinicians and laboratory technicians were recruited conveniently from TB clinics of respective facilities. Qualitative content analysis was adopted using ATLAS ti. Results: Placement of GeneXpert machines in laboratories was reported by majority of participants to allow for dual testing of TB, point of care early infant diagnosis for HIV and HIV viral load monitoring. Experiences of power cuts with unreliable back-up power supply, cartridges stockouts and module breakdowns were reported by all clinicians to encompass challenges encountered by facilities. Complaints relating to delays in fixing modules and receipt of ordered cartridges were additional challenges reported by all laboratory technicians. These were translated to delays in initiation of TB treatment and pre-treatment loss to follow-up. Timely ordering and keeping inventory of stocks, ensuring constant supply of diagnostic tools as well as personal ownership of TB department were perceived as solutions in addressing challenges described. Conclusion: GeneXpert was perceived as beneficial however, facility challenges constitute underlying reasons for sub-optimal use for TB diagnosis. These may translate to low notification of bacteriologically confirmed cases. Strengthening of facility laboratory infrastructure and addressing health system bottlenecks are among strategies to improve conditions necessary for GeneXpert testing.
- Subjects
TANZANIA; HEALTH facilities utilization; TUBERCULOSIS; HEALTH facilities; LABORATORY technicians; QUALITATIVE research
- Publication
Tanzania Journal of Health Research, 2022, Vol 23, p128
- ISSN
1821-6404
- Publication type
Article