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Universal Access to Xpert MTB/RIF Testing for Diagnosis of Tuberculosis in Uzbekistan: How Well Are We Doing?

Author

Listed:
  • Laziz Turaev

    (National Reference Laboratory, Tashkent 100086, Uzbekistan)

  • Ajay Kumar

    (International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi 110016, India
    International Union Against Tuberculosis and Lung Disease, 75006 Paris, France
    Yenepoya Medical College, Yenepoya (Deemed to be University), Mangaluru 575018, India)

  • Dilyara Nabirova

    (United States Centers for Disease Control and Prevention, Central Asia Region, Almaty A25T0A1, Kazakhstan)

  • Sevak Alaverdyan

    (Bielefeld Graduate School of Economics and Management (BiGSEM), Bielefeld University, Universitätsstraße, 33615 Bielefeld, Germany)

  • Nargiza Parpieva

    (National Tuberculosis Programme, Ministry of Health, Tashkent 100086, Uzbekistan)

  • Barno Abdusamatova

    (Ministry of Health, Tashkent 100086, Uzbekistan)

Abstract

As per national guidelines in Uzbekistan, all presumptive tuberculosis patients should be tested using the Xpert MTB/RIF assay for diagnosing tuberculosis. There is no published evidence how well this is being implemented. In this paper, we report on the Xpert coverage among presumptive tuberculosis patients in 2018 and 2019, factors associated with non-testing and delays involved. Analysis of national aggregate data indicated that Xpert testing increased from 24% in 2018 to 46% in 2019, with variation among the regions: 21% in Tashkent region to 100% in Karakalpakstan. In a cohort (January–March 2019) constituted of 40 randomly selected health facilities in Tashkent city and Bukhara region, there were 1940 patients of whom 832 (43%, 95% confidence interval (CI): 41–45%) were not Xpert-tested. Non-testing was significantly higher in Bukhara region (73%) compared to Tashkent city (28%). In multivariable analysis, patient’s age, distance between primary health centre (PHC) and Xpert laboratory, diagnostic capacity and site of PHC were associated with non-testing. The median (interquartile range) duration from date of initial visit to PHC to receiving results was 1 (1–2) day in Tashkent city compared to 3 (1–6) days in Bukhara region ( p -value < 0.001). While there is commendable progress, universal access to Xpert testing is not a reality yet.

Suggested Citation

  • Laziz Turaev & Ajay Kumar & Dilyara Nabirova & Sevak Alaverdyan & Nargiza Parpieva & Barno Abdusamatova, 2021. "Universal Access to Xpert MTB/RIF Testing for Diagnosis of Tuberculosis in Uzbekistan: How Well Are We Doing?," IJERPH, MDPI, vol. 18(6), pages 1-13, March.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:6:p:2915-:d:515834
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