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GeneXpert in Kyrgyzstan: How does it work? a short DEMONSTRATION of faster and more accurate TB diagnosis systems

Until recently in Kyrgyzstan, the most accurate way to diagnose tuberculosis was by cultivating bacteria from a patient's biological sample in a laboratory. This method has the advantage of detecting drug sensitivities of the tested TB strain, but the process can take between five days and two months.

This relatively lengthy process can have negative consequences for TB patients who need to start the right treatment as fast as possible to maximize their chances to heal.

A laboratory technician looks through a microscope to examine samples.

Fortunately, over the past few years a total of 24 GeneXpert testing systems were installed in various laboratories across the country. This system is able to deliver an accurate diagnosis, including information about drug resistance, in only two hours.

The USAID Defeat TB Project, with the support of the United States Agency for International Development, provides technical assistance to these laboratories for the installation of the GeneXpert machines. The Defeat TB Project also continuously trains lab technicians on how to use and maintain the machines.

Ms Ermakova at a GeneXpert terminal station, getting ready to run a series of tests.

Ms Kandalat Ermakova works in a laboratory in the Suzak rayon near Jalal-Abad in southern Kyrgyzstan. About a year and half ago, her laboratory was equipped with a GeneXpert terminal. Our Project was then able to provide her and her colleagues with a series of trainings on using the machines, including how to observe infection control measures when running the tests.

Ms Ermakova knows how to wear protective clothes to manipulate biological samples.

After putting on protective clothes, Ms Ermakova takes biological samples stored in a refrigerator. Each container is sealed and contains body fluids, called sputum, collected on site from patients suspected of having tuberculosis.

Each step is carefully followed as per established protocols to avoid errors and keep lab workers safe.

In each container, Ms Ermakova adds a reacting agent, mixes it with the biological sample, and let the solution rest for a few minutes. Once the sample is ready, she adds a few milliliters of the mix to a special GeneXpert cartridge. Each step is carefully documented to avoid errors.

Each cartridge has a unique code that allows the accurate tracing of the tested samples. All the data is digitized and entered in a database accessible by all TB specialists in the country.

After scanning the cartridge, Ms Ermakova inserts it in the GeneXpert machine. A total of four cartridges can be processed at a time. After about two hours, the results are ready and instantly shared with the TB specialists involved in a particular case.

Since the GeneXpert system was installed in her lab in February 2016, Ms Ermakova has completed four different trainings. She is now able to run between 12 and 16 tests per day, 6 days per week.

As a result of all this, Ms Ermakova's work environment is safer, the results of her test are more quickly available, and also they are more accurate. Most importantly, this allows patients diagnosed with the disease to rapidly start a treatment that is also the most appropriate for them.

The USAID Defeat TB Project is a five-year endeavor designed to reduce the burden of tuberculosis (TB) in the Kyrgyz Republic. Its implementation limits the development of drug-resistant strains of the disease, supports equitable access to quality health care for vulnerable groups, and strengthens the national healthcare system.

This publication is made possible by the support of the American people through the United States Agency for International Development (USAID). The contents are the sole responsibility of Abt Associates Inc. and do not necessarily reflect the views of USAID or the United States Government.
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Credits:

Olivier Le Blanc

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