Stop TB Partnership

Gene Xpert MTB/RIF in Kiribati: a historical milestone

23 February 2015 - Kiribati - The National Tuberculosis Program (NTP) in Kiribati will be more efficient in diagnosing tuberculosis and able to detect rifampicin resistance with its newly introduced Gene Xpert machine. With funding and technical support from the Australian Aid Program and the Secretariat of the Pacific Community (SPC) respectively, Kiribati NTP was able to purchase and install its Gene Xpert machine. From 5th February 2015 onwards, NTP will be able to perform TB diagnosis at a cheaper cost, laboratory personnel would provide feedback to clinicians within two hours, and capable of applying a robust TB drug resistant surveillance, particularly for rapid detection of resistance to rifampicin.

Kiribati is off-track with its health related MDGs, faced with a sequence of communicable disease outbreaks, and is grappling with an unfolding NCD crisis. Since 2003, Kiribati has been reporting the highest rates of TB in both the Pacific and Western Pacific WHO regions with annual case notification ranging from 350-400 per 100,000population. The NTP, with assistance from its development partners such as Australia, SPC, WHO and the Global Fund has embarked on developing and implementing effective DOTS strategies to control TB in Kiribati. Gene Xpert is one of them.

TB incidence (per 100,000pop) in Kiribati 2001-2013. Source- SPC

The NTP has a dedicated laboratory that practices sputum smear microscopy and culture to confirm TB. From 5th February 2015 to 12th February 2015, 25 clinicians and 5 lab technicians underwent training on laboratory procedures to diagnose TB with particular focus on the Gene Xpert machine. This training was facilitated by Mr Richard Lumb from South Australia Pathology, an Adelaide based laboratory. Mr Lumb was part of the Technical Advisory Group (TAG) commissioned by the Australian Aid backed-SPC/Ministry of Health’s ‘Towards TB Elimination in Kiribati (TTBEK)’ project to provide specialist assistance to NTP.

Given the high specificity and sensitivity of Gene Xpert, a quicker decision to commence treatment would be possible therefore stopping the transmission of TB bacilli in communities. This would help reverse the alarming TB epidemiology that is currently experienced in Kiribati. Such historical undertaking in the health sector will help drive communities to achieve wellness and consequently improve their socioeconomic status.

L-R: TB nurse Salamo; TB Coordinator Bereke Reiher; SPC TB Adviser Mr Jojo Merilles; TTBEK project Adviser Dr Takeiete Kienene; Mr Richard Lumb; NTP Manager Dr Alfred Tonganibeia - beside their new Gene Xpert machine