Stop TB Partnership

The Union's SPARK-TB Plus program introduces Xpert MTB/RIF testing to the private sector in Uganda

20 January 2015 - Uganda - The introduction and WHO endorsement of the Xpert MTB/RIF assay in 2010 revolutionized TB diagnosis. The assay's improved sensitivity and specificity compared with smear microscopy means it is able to confirm TB disease in smear negative patients. This provides a huge benefit to people living with HIV/AIDS who often test negative by smear microscopy. In addition, the Xpert MTB/RIF test reduces the time needed to diagnose resistance to rifampicin from six weeks to just two hours. In Uganda, the first GeneXpert system was placed in the National Referral Hospital in Mulago in 2011. Since then, the National TB and Leprosy Program (NTLP) has installed 59 systems countrywide.

With funding provided by the Stop TB Partnership's TB REACH initiative, the NTLP and The Union established the SPARK-TB Plus program, a wide-ranging public-private mix project to improve TB care and expand access to the Xpert MTB/RIF assay in the urban slums of Kampala and 12 peri-urban areas outside the city. Since its inception, the SPARK-TB Plus program has strengthened the capacity clinicians, nurses, laboratory technician and health workers at 150 private health facilities diagnose and treat TB.

Two GeneXpert systems were installed at high-volume private facilities and a referral network of private providers was set up to increase testing volumes. The Xpert MTB/RIF test is offered free of charge to patients (similar to testing services offer at public healthcare facilities), and those detected by the assay are linked to quality-assured treatment following NTLP guidelines. This move has been welcomed by TB patients, health care workers and district health officers. For the first time, TB patients who visit private health facilties are now receiving the same standard of care as those tested, detected and treated at government facilities.

More details about the Spark-TB Plus program, can be found in Improving Tuberculosis Case Detection: A compendium of TB REACH case studies, lessons learned and a monitoring evaluation framework.