Prerequisites for Xpert MTB/RIF Implementation

19 items · Health · Medium difficulty · 30 min

Key country-level steps to prepare for Xpert MTB/RIF rollout.

• Review national TB burden and testing gaps

  Check recent case data and lab coverage to justify Xpert rollout.

• Secure government commitment and budget

  Obtain formal approval and line items for equipment, cartridges, and operations.

• Update national diagnostic policy to include Xpert

  Define who gets tested and how Xpert fits with existing algorithms.

• Identify priority health facilities and laboratories for rollout

  Map high-burden areas and referral networks to choose initial sites.

• Verify power supply, lab space, and biosafety needs

  Confirm reliable electricity, bench space, and basic biosafety measures.

• Plan procurement for machines and consumables

  Decide models, quantities, and procurement timelines for devices and cartridges.

• Order GeneXpert machines

  Place orders with approved suppliers and track delivery timelines.

• Order cartridges and laboratory consumables

  Forecast initial and buffer stock levels; include shipment lead time.

• Arrange maintenance, warranty, and service contracts

  Set up local support, spare parts, and a plan for device downtime.

• Train laboratory technicians on Xpert operation

  Provide hands-on training covering test running, troubleshooting, and QC.

• Set up sputum collection, transport, and specimen handling

  Define sample containers, labeling, and transport timing/conditions.

• Start a quality assurance program and enroll in EQA

  Implement internal controls, periodic proficiency testing, and audits.

• Integrate Xpert results into national reporting systems

  Ensure electronic or paper reporting feeds into surveillance and patient records.

• Define testing algorithms and clinical guidelines

  Specify indications, confirmatory testing, and links to treatment pathways.

• Create a forecasting plan for cartridges and supplies

  Use consumption data and buffer stock rules to prevent stockouts.

• Implement waste management and cartridge disposal procedures

  Set safe disposal protocols for used cartridges and infectious waste.

• Set indicators and monitor test volumes, positivity, and errors

  Track key metrics regularly to evaluate performance and quality.

• Inform clinicians, community workers, and partners about rollout

  Share eligibility criteria, expected turnaround times, and referral paths.

• Develop a long-term scale-up and sustainability plan

  Plan financing, training refreshers, and phased expansion.

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