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North West Dept of Health
Klerksdorp/Tshepong Hospital Complex
Fax: 018 4625923. Tel: 018 406 3111. [email protected]
Media release
For immediate Release 11.03.2013
GeneXpert TB testing medical equipment helps saving lives by
expedites turnaround time for diagnoses of TB.
The fight against TB in the North-West Province continues to record positive outcomes. The management
of Klerksdorp/Tshepong hospital complex in its quest to reduce the spread of TB is proud to announce that
since the usage of installed GeneXpert TB testing machine in 2011 at Tshepong hospital TB laboratory
services, there has been a remarkable turnaround in diagnosis of TB and TB treatment intervention for our
patients.
This is the first new medical equipment in the Department of Health's artillery against TB as the building of
hospital facilities to house MDR- and XDR-patients only, means patient will get better quickly with
administering proven excellent TB medication of efficacy. MDR unit in Tshepong is the highest cure rate,
and less defaulter rate as compared to other MDR /XDR TB units in the country. The unit managed to
separate patients and group them according to their common infections, thus, controlling nosocomial
infections. The conversion rate is high and most patients are able to convert in the early stages of treatment
within 2 -3 months.
The GeneXpert TB diagnostic device at Tshepong hospital is used to prepare a sample of sputum to be
inserted into the diagnostic device. This quick and accurate diagnosis of the GeneXpert has a lot more
value than merely efficiency. Because of early quick and accurate diagnosis the 2012 statistics shows that
a total of 1964 MDR TB patients were diagnosed and went through the MDR TB program, of which 469
were admitted, 280 discharges, with about 65 % cure rate and = 4 343 outpatients.
Diagnosis result of the genexpert machine takes two hours, thus, provide same-day diagnosis, which
means a person is put on treatment immediately, and doesn't go around their community spreading the
bacteria without knowing they're are highly infectious as it was the case in the past. The GeneXpert is also
a lot less resource intensive and as tests can be done locally. Also, sputum samples don't have to be sent
for laboratory testing somewhere else.
There is positive trails research in TB research, with total commitment that is seen, and compassionate
quality service delivery, the department hopes to ultimately reduce TB in all respects. Tuberculosis is one of
the deadliest public health threats today, but there remains a lack of effective diagnostic tools. Traditionally,
tuberculosis is mostly being diagnosed by a combination of chest X-rays, the staining of sputum with
special stains followed by microscopy, the growth of Mycobacterium tuberculosis in culture and the
Mantoux test. These methods have problems of sensitivity, specificity and/or speed. Drug susceptibility
could only be diagnosed from the growth of Mycobacterium tuberculosis in culture which can take as long
as six to twelve weeks for the results to become available and fails in many cases.
The determination of drug susceptibility is particularly relevant because Mycobacterium tuberculosis
becomes increasingly resistant to two of the major anti-tuberculosis drugs, isoniazide and rifampicin. This
form of tuberculosis is called multi-drug-resistant tuberculosis (MDR-TB) and needs to be treated with
different antibiotics. It is therefore relevant to detect cases of MDR-TB in as short a time as possible,
because these patients remain a source of infection even if treated in the standard manner.
The Gene Xpert is a machine that can detect Mycobacterium tuberculosis in a sputum sample. The sample
is fed into the machine, and then biochemical reactions are started to see if the sample contains the TB
bacterium. If there are TB bacteria in the sample, the machine will detect their DNA and automatically
multiply it.
This technique is called PCR (polymerase chain reaction), and allows the machine to also look at the
structure of the genes. This is important to detect if a TB bacterium has developed resistance to drugs. If
there has been a mutation in the DNA, the bacterium can become resistant to certain TB drugs. The Gene
Xpert tests for resistance to Rifampicin.
This means that it can tell us two things: first, whether or not a person has TB, and second, whether or not
the TB that the person has can be treated with Rifampicin. The test is much faster than the other TB tests
and the results are available within 1 day.
The Gene Xpert comes in various sizes. The smallest machine has a capacity for four cartridges (in other
words four tests can be run at a time). The largest has capacity for 100 cartridges. The local NHLS
laboratories are equipped with GeneXpert instruments in various sizes and the GeneXpert test has been
offered locally since the official launch of the test in S.A. in 2011. This is the preferred test for screening
suspected TB cases.
By Nico Masiu
AD: Communications, KT Hospital Complex
Cell: 0823982602; Tel: 018 4064600, fax: 018 4625923
[email protected]