Related Experiment Video
Updated: Apr 3, 2026
Diagnosing Pulmonary Tuberculosis with the Xpert MTB/RIF Test
Published on: April 9, 2012
Countrywide roll-out of Xpert(®) MTB/RIF in Swaziland: the first three years of implementation
W Sikhondze1, T Dlamini2, D Khumalo3
1National Tuberculosis Control Programme, Mbabane, Swaziland ; Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland.
Setting:
All 19 public health laboratories in Swaziland that had Xpert(®) MTB/RIF machines installed as part of a countrywide roll-out between June 2011 and June 2014.
Objective:
To evaluate the utilisation and functionality of Xpert from 2011 to mid-2014.
Design:
Descriptive study of Xpert implementation using routinely collected data.
Results:
Of 48 829 Xpert tests conducted, 93% were successful: 14% detected Mycobacterium tuberculosis and 12% showed rifampicin resistance. The most common cause of unsuccessful tests was an 'Error' result (62%). Similar findings were obtained in government-supported and partner-supported laboratories. Annual utilisation of Xpert improved from 51% of maximum capacity in 2011 and 2012 to 74% in 2013 and 2014. A monitoring and supervision exercise of all Xpert testing sites in 2014 showed a generally good performance, with over 50% of laboratories achieving a ⩾80% score on most components. However, poor scores were obtained with equipment use and maintenance (6% achieving a score of ⩾80%), internal audit (19% achieving a score of ⩾80%) and process control (25% achieving a score of ⩾80%).
Conclusion:
Countrywide roll-out of Xpert in Swaziland has been successful, although operational issues have been identified and need to be resolved.
