GeneXpert Expansion for APOPO TB Mozambique

By Dr. Emilio Valverde | Country Program Manager, APOPO TB Mozambique

APOPO TB Mozambique responds to the national rollout of GeneXpert technology.

Last year the Stop TB Partnership and the Global Fund joined forces to contribute towards finding and treating an additional 1.5 million people with tuberculosis who are currently missed by health systems in 13 high TB-burden countries including Mozambique. Till now the APOPO TB program has been maintaining full coverage of all microscopy TB suspect samples produced in the city of Maputo. However, in 2017 Mozambican health authorities started a roll out of the GeneXpert technology with the TB test Xpert MTB/RIF. This substitution of microscopy by Xpert resulted in a lower number of samples received by APOPO so APOPO decided to make the same switch to deal with this new situation

GeneXpert technology was endorsed by the World Health Organization (WHO) in 2010. It involves a molecular TB test detecting the DNA in TB bacteria, also being able to indicate if a patient may have multidrug-resistant TB. The WHO recommended that Xpert MTB/RIF be used as the initial diagnostic test in patients suspected of multidrug-resistant TB or HIV-associated TB. The global rollout of GeneXpert machines started soon after. The WHO did also emphasize that conventional microscopy culture and drug sensitivity testing are still needed, as these are required to monitor treatment progress and to detect other types of drug resistance in the clinics. The GeneXpert MTB/RIF cannot be used for treatment monitoring, as it detects both live and dead bacteria.

APOPO in Mozambique is currently finishing off an expansion of the project facilities at the Veterinary School of the Eduardo Mondlane University in Maputo. Over the last few weeks the original APOPO building has been extended and will have a dedicated GeneXpert laboratory as well as additional workspace. These are required for an increase in project activities as a result of the change of rat indication confirmation method from microscopy to GeneXpert testing.

APOPO has already purchased a 16-module GeneXpert machine, which will allow APOPO to confirm close to 100 samples daily. Medecins Sans Frontieres (MSF) Switzerland operates in some of Maputo’s clinics and they have agreed to supply APOPO with GeneXpert cartridges for confirmation testing of samples coming from those clinics. APOPO is also in talks with the Maputo City Health Directorate to integrate APOPO’s laboratory in the National Health System network, so it can also receive cartridges straight from the Ministry of Health depots. The new GeneXpert machine is already set up in APOPO’s newly built laboratory, being the first 16-module machine in the Republic of Mozambique, and positioning APOPO as a key partner for the Maputo City Health Directorate. This is a significant step forward in the intention of the Maputo health authorities to reach complete GeneXpert coverage in the city.

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