Assessment of Reasons for Service Interruption and Unsuccessful Test Results Related to GeneXpert Diagnostic Service in Addis Ababa Public Health Facilities.
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Date
2021-01
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Addis Abeba University
Abstract
Background: Tuberculosis (TB) was one of the top 10 causes of death worldwide in 2018. It is
also the leading killer of people with HIV and a major cause of deaths related to antimicrobial
resistance. Ethiopia is among the 30 high burden tuberculosis countries, with annual estimated
TB incidence of 151/100,000 population and HIV negative TB mortality of 22/100,000 population
as of 2018 global TB report. At present, the major problem in managing TB is lack of an accurate
and rapid diagnostic test. Accordingly, rapid diagnostic test for detection of TB and rifampicin
resistance currently available is the GeneXpert assay as WHO recommended. However health
facilities which having GeneXpert diagnostic device encountered different challenges during
implementation.
Objective: This study was aim to assess the reasons for service interruption and Unsuccessful test
results related to GeneXpert diagnostic service in Addis Ababa public health facilities.
Methods: Cross sectional study design was conducted in public health facilities which provided
GeneXpert diagnostic service in Addis Ababa, Ethiopia. Quantitative and qualitative
questionnaires based data was collected from January to March 2020. The data was cleaned,
entered and analyzed using SPSS version 20 at a statistical significance of P value ≤ 0.05 using
logistic regression. While the qualitative data obtained was summarized in thematic narrative
form.
Results: Reasons of GeneXpert diagnostic services resulted to service interruptions and
unsuccessful test results identified in this study. At least once or more than one times of service
interruption of GeneXpert were occurred in 82% of the health facilities in the study period. Service
interruption were dependent on the stock out of cartridge (
X2
=10.6, p value <0.01). While, a total
of 4% (1078/26998) unsuccessful test result were occurred, of which 2.3% (618/26998) was due
to ‘Error’ followed by ‘No result’ 1.2% (334/26998) and ‘Invalid’ 0.5% (126/26998).
Conclusion: The main reasons of GeneXpert diagnostic service which resulted to service
interruptions were stock out of cartridge, machine down, system failure, module failure and
cartridge malfunction. In the other hand, insufficient sample volume, power interruption, poor
sample quality, food contaminant and technical errors were reasons for unsuccessful test result.
Thus, sustainable power supply, responsive maintenance support, sustainable supply chain system
and refresher training are at most important.
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Keywords
Reasons, Error, GeneXpert