Improving Utilisation of GeneXpert Testing at Five Lab Hubs in Northern Uganda

The GeneXpert test is a molecular test that detects Tuberculosis (TB) bacteria DNA as well as some genetic mutations associated with TB treatment resistance. The test uses samples like cerebrospinal fluid and pleural fluid and gives results in less than two hours. Since January 2016, the USAID Applying Science to Strengthen and Improve Systems project (ASSIST) has supported five district laboratory hubs in northern Uganda that have GeneXpert machines to increase the TB case notification rate by increasing the number of samples processed using the GeneXpert machine. In only one month, the facilities raised the number of GeneXpert samples processed from a total of 91 samples to 164 samples through testing changes including assigning a focal person to oversee GeneXpert utilization by placing sputum containers at the HIV clinic. The laboratory team greatly improved the quality of records management by improving the accuracy and completeness of all information in laboratory TB register. Weekly reporting to the national TB reference laboratory on the GeneXpert tests done at each facility also improved. This case study emphasizes the simple steps that facility quality improvement (QI) teams took to make these changes without additional resources and in a short time period.

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