Impact Of Increased Diagnostic Tools (GeneXpert, TB-Lamp and Truenat) On Tuberculosis Case Finding
1
Programs, Association for Reproductive and Family Health, Ilorin, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Limited access to diagnostic tools remains a major challenge to timely tuberculosis (TB) detection in Nigeria. Before the Global Fund Grant Cycle 7 (GC-7), Kwara State depended solely on a limited number of GeneXpert platforms that were not easily accessible, especially in hard-to-reach areas. This resulted in delayed turnaround time (TAT) of 4-5 days, sometimes several months during national testing campaigns, low sample testing, low case notification, and frequent movement of samples across LGAs for diagnosis.
METHODS:
During Grant Cycle 6 (GC-6), only eight GeneXpert machines were available across eight LGAs, leading to prolonged TAT of over 5-7 days during peak testing periods and low TB case detection. In GC-7, additional diagnostic tools, including TB-LAMP and Truenat MTB/RIF were procured and strategically deployed to underserved and high-burden LGAs to expand diagnostic coverage. These tools improved screening, reduced TAT to 1-2 days, increased case notification, and minimized inter-LGA movement. Implementation strategies included strategic placement of diagnostic platforms, capacity building for facility staff and sample movers, real-time monitoring of sample flow, and optimization of tools during routine and high-burden testing periods. A retrospective analysis of routine specimen referral data from 2023 – 2025 was conducted using TB/EID dashboards, DHIS2, and Google Sheets. Key indicators included sample volume, test results, and case notification.
RESULTS:
Diagnostic platforms increased from 8 (2023) to 23 (2025). Sample testing increased by 97% (11,310 to 22,298), TB-positivity increased by 105% (702 to 1,436). GeneXpert/Truenat contributed the highest yield (86%). Case notification increased by 39% (1,828 to 2,529). PPM contribution(17.7% to 51.5%).
CONCLUSIONS:
Integrating TB-LAMP and Truenat significantly improved diagnostic coverage, reduced TAT, and enhanced TB case detection. Sustaining these requires continuous monitoring, timely maintenance, and equitable distribution of diagnostic commodities. Expanding molecular diagnostic tools to every LGA is essential for achieving national and global End TB targets.
Limited access to diagnostic tools remains a major challenge to timely tuberculosis (TB) detection in Nigeria. Before the Global Fund Grant Cycle 7 (GC-7), Kwara State depended solely on a limited number of GeneXpert platforms that were not easily accessible, especially in hard-to-reach areas. This resulted in delayed turnaround time (TAT) of 4-5 days, sometimes several months during national testing campaigns, low sample testing, low case notification, and frequent movement of samples across LGAs for diagnosis.
METHODS:
During Grant Cycle 6 (GC-6), only eight GeneXpert machines were available across eight LGAs, leading to prolonged TAT of over 5-7 days during peak testing periods and low TB case detection. In GC-7, additional diagnostic tools, including TB-LAMP and Truenat MTB/RIF were procured and strategically deployed to underserved and high-burden LGAs to expand diagnostic coverage. These tools improved screening, reduced TAT to 1-2 days, increased case notification, and minimized inter-LGA movement. Implementation strategies included strategic placement of diagnostic platforms, capacity building for facility staff and sample movers, real-time monitoring of sample flow, and optimization of tools during routine and high-burden testing periods. A retrospective analysis of routine specimen referral data from 2023 – 2025 was conducted using TB/EID dashboards, DHIS2, and Google Sheets. Key indicators included sample volume, test results, and case notification.
RESULTS:
Diagnostic platforms increased from 8 (2023) to 23 (2025). Sample testing increased by 97% (11,310 to 22,298), TB-positivity increased by 105% (702 to 1,436). GeneXpert/Truenat contributed the highest yield (86%). Case notification increased by 39% (1,828 to 2,529). PPM contribution(17.7% to 51.5%).
CONCLUSIONS:
Integrating TB-LAMP and Truenat significantly improved diagnostic coverage, reduced TAT, and enhanced TB case detection. Sustaining these requires continuous monitoring, timely maintenance, and equitable distribution of diagnostic commodities. Expanding molecular diagnostic tools to every LGA is essential for achieving national and global End TB targets.
| eISSN: | 2654-1459 |
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