Skip to content
Research Article Open access CC BY 4.0

Evaluating the Impact of the GeneXpert Technique on Case Detection and Management of Tuberculosis in Ghana

Felix Kodzo Besah Sorvor, Ebenezer Ato Ewusie

Asian Journal of Medicine and Health · pp. 241–252 · Published 22 Aug 2023

10.9734/ajmah/2023/v21i10899

Abstract

Background: Rapid and more sensitive diagnostic assays have seen substantial investment globally intending to improve Tuberculosis (TB) diagnosis towards treatment. This study evaluated the impact of the GeneXpert intervention on TB case detection and management in Ghana. Methods: The study made use of an interrupted time series design. Data from Ghana’s District Health Information Management System (DHIMS II) was used to evaluate the impact of the intervention. A cross-section of DHIMS II data was analyzed repeatedly using 2017 and 2022 as baseline and end lines, respectively. Descriptive analysis and interrupted time series models were used. Results: No immediate impact was observed on bacteriologically confirmed TB, however, 5 years following the intervention, the number of bacteriologically confirmed TB cases increased by an average of 562 cases per year (step and ramp (coefficients of pre- and post-intervention ) variables being -278.5 (95% (CI): -1118.3, 561.3) and 561.9 (95% CI: 352.3, 771.6), respectively. The cure rate decreased on average by 32.8% at the onset (step coefficient of -32.8 (95% CI: 40.5 – 25.0), however, there were no significant changes in the pre-and post-intervention cure rates (ramp coefficient = 1.5 (95% CI: -4.0, 7.0). Subsequently, the treatment completed rate increased sharply in the year of implementation but did not significantly differ from the pre-and post-intervention period (step and ramp coefficients were 29.4% (95% CI: 27.0, 31.9) and 1.5% (95% CI: -1.8, 0.4). Moreover, the intervention did not have a significant sudden or gradual impact on adverse treatment outcomes; step and ramp coefficients were 3.0% (95% CI: -4.5, 10.6) and 0.2% (95% CI: -5.1, 5.5) Conclusions: While bacteriologically diagnosed TB cases improved during the implementation period, clinical outcomes were not significantly impacted. To achieve recommended global targets, there is a need to address treatment follow-up challenges and enhance monitoring as part of addressing implementation challenges.

Tuberculosis GeneXpert intervention interrupted time series impact

References (17)

  1. 1 Home visits: a strategy to improve newborn survival - Authors' reply [DOI]
  2. 2 WHO's new End TB Strategy [DOI]
  3. 3 Interrupted time series analysis using autoregressive integrated moving average (ARIMA) models: a guide for evaluating large-scale health interventions [DOI]
  4. 4 The use of controls in interrupted time series studies of public health interventions [DOI]
  5. 5 Implementation of GeneXpert for TB Testing in Low- and Middle-Income Countries: A Systematic Review [DOI]
  6. 6 Diagnostic performance of GeneXpert MTB/RIF in detecting MTB in smear-negative presumptive TB patients [DOI]
  7. 7 Effect of Xpert MTB/RIF on clinical outcomes in routine care settings: individual patient data meta-analysis [DOI]
  8. 8 Factors influencing active tuberculosis case-finding policy development and implementation: a scoping review [DOI]
  9. 9 The implementation of Xpert MTB/RIF assay for diagnosis of tuberculosis in Nepal: A mixed-methods analysis [DOI]
  10. 10 Evaluation of GeneXpert MTB/RIF for detecting Mycobacterium tuberculosis in a hospital in China [DOI]
  11. 11 Predictors of Adverse TB Treatment Outcome among TB/HIV Patients Compared with Non-HIV Patients in the Greater Accra Regional Hospital from 2008 to 2016 [DOI]
  12. 12 GeneXpert rollout in three high-burden tuberculosis countries in Africa: A review of pulmonary tuberculosis diagnosis and outcomes from 2001 to 2019 [DOI]
  13. 13 The additional yield of GeneXpert MTB/RIF test in the diagnosis of pulmonary tuberculosis among household contacts of smear positive TB cases [DOI]
  14. 14 Factors affecting TB case detection and treatment in the Sissala East District, Ghana [DOI]
  15. 15 Diagnostic performance of GeneXpert in tuberculosis–HIV co–infected patients at Asella Teaching and Referral Hospital, Southeastern Ethiopia: A cross sectional study [DOI]
  16. 16 The Good, the Bad and the Ugly of the Next-Generation Xpert Mtb/Rif ® Ultra Test for Tuberculosis Diagnosis [DOI]
  17. 17 Evaluating Interventions [DOI]

Cited by 2

Probe amplifications in the Xpert MTB/RIF Ultra assay for non-tuberculous mycobacteria identified from diabetes mellitus and chronic kidney disease patients in Ethiopia

A. Alemu, G. Diriba, Getachew Seid · Scientific Reports · 2025

Showing 1 of 2 known citations — external sources report more than can currently be individually listed.

Related research

Article metrics

Real usage data collected on this platform.

0

Page views

0

PDF downloads

0

Outbound clicks

2

Citations

Views by country

Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".

No views recorded yet.

Traffic sources

Referring site, by host.

No traffic recorded yet.

Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.