Overcoming Maintenance Challenges Associated with GeneXpert Machines — Experience in Bangladesh

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GeneXpert has revolutionized the diagnosis of tuberculosis (TB) and drug resistant TB (DR-TB) by effectively detecting M. tuberculosis in clinical specimens and RMP resistance in less than two hours without sophisticated laboratories. This enables patients to begin treatment for rifampicin resistant TB on the same day, rather than after several months of ineffective treatment.

Through the TBCARE II Project, USAID supported the expansion of NTP’s diagnostic capacity and installed 39 GeneXpert machines between 2012 and 2014. Most of the machines (23) were placed in district level Chest Disease Clinics (CDCs) across the country; the remaining 16 are in tertiary level hospitals in Dhaka City, including the Chest Disease Hospital-CDH, National TB Reference Laboratory-NTRL, Regional TB Reference Laboratories- RTRLs and specialized hospitals (Figure 1).

In April 2015, as the TB CARE II project phased out, Challenge TB Bangladesh, implemented by Management Sciences for Health (MSH), took responsibility for operationalizing the 39 GeneXpert machines (228 modules in a total) in 38 centers across the country.

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