19 October-30 November 2020
The 51st Union World Conference On Lung Health


Channel 6
SP-26-Leveraging a multiplex platform for TB, HIV and coronavirus for diagnostic testing and clinical monitoring: country experiences
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SP-26-Leveraging a multiplex platform for TB, HIV and coronavirus for diagnostic testing and clinical monitoring: country experiences
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(i) To share country experiences in using multiple disease cartridges within the GeneXpert network.
(ii) To give examples of country lessons learned during the COVID-19 outbreak.
(iii) To advocate for rationale investments and standard operating procedures to avoid TB diagnostic disruptions.

16:30 - 16:35: Introduction

16:35 - 16:45: Introduction and overview of the current COVID-19 situation and impact on TB program with issues of IntegrationGlobally, TB services are one of the biggest casualties of the Covid-19 pandemic. TB notifications have dropped because patients with TB symptoms are reluctant to seek care or simply unable to get care. TB laboratories and resources are being re-directed to Covid-19 testing. This means that undiagnosed TB patients will continue to remain infectious for a longer period, increasing community transmission. They will be more likely to end up with advanced (smear-positive and cavitary TB), which, in turn, could increase the risk of mortality. It is critical to address these gaps in the cascade of care and bring back TB diagnostic services to pre-pandemic levels.
Madhukar Pai

16:45 - 16:55: Authorized service provision for GeneXpert through KNCV in Nigeria: shifting GeneXpert network from a TB diagnostic network to a multiplexed network with sufficient capacityThe vast majority of the 407 GeneXpert machines installed across Nigeria were originally placed solely for the diagnosis of TB. Additional test menus have since been adopted for use on the available instruments such as HIV, Hepatitis B and C Viral load, EID, HPV amongst others. Most recently the instruments are adding the Xpert Xpress SARS-CoV -2 cartridges to the test menu for the diagnosis of the novel corona virus as this is the most accessible method for use in testing for COVID in Nigeria. As other test menus come aboard the GeneXpert network, it is important that TB diagnosis is not pushed aside at the cost of TB patients and communities.
Prisca Ajiboye

16:55 - 17:05: The National TB program of the Kyrgyz Republic response to the COVID-19 pandemicThe Ministry of Health (MoH) of the Kyrgyz Republic organized a coordination body to manage a COVID-19 response with the TB and HIV management teams. The government, with WHO support, developed a comprehensive plan with salary increases for health care workers involved in testing and treatment of patients with COVID-19. The MoH endorsed the guidelines on COVID-19 management with inclusion of TB management. The NTP approved distribution of TB drugs for 14 days with VideoDOT. The MDR-TB department of the NTP for 30 patients was redesigned for patients with COVID-19. They procured medical,l prevention and infection control equipment for management of patients with COVID-19. In the lockdown period, the  UNDP, NRCS and NTP provided cars for distribution of TB drugs. Laboratory specialists from the NRL formed part of COVID-19 mobile teams. The NTP in collaboration with the HIV center prepared a proposal to the Global Fund on COVID-19.  
Elmira Abdrakhmanova

17:05 - 17:15: Optimization of the GeneXpert network to leverage COVID-19 testing in IndonesiaTesting coverage and quality diagnosis are key to the flattening of the COVID-19 curve. Indonesia has utilized the SARS-CoV-2 RT-PCR for COVID-19 diagnosis. Early in the pandemic, a scarcity of COVID-19 referral laboratories limited testing and diagnosis of infection. To increase COVID-19 testing, the Indonesian government established new testing centres. Moreover, due to availability of SARS-CoV-2 Xpert cartridges, the Ministry of Health further expanded access to COVID-19 testing by utilizing and optimizing the GeneXpert and specimen transport network of TB and HIV programs. They  issued new policies regulating multiple use of GeneXpert machines for TB, HIV and COVID-19 diagnosis.  We will present experiences from Indonesia in implementing multiplex platforms for TB, HIV and COVID-19 diagnosis using existing GeneXpert instruments and RT-PCRs nationwide. We will present data on risk assessment results, availability of reagents, specimen transport, recording and reporting, and impact of the new policies on TB and HIV diagnostic services. 
Siti Nadia

17:15 - 17:25: How the Rwandan National Reference Laboratory (NRL) rearranged its Multiplex PCR capacity to meet the huge COVID-19 testing demandBuilding on influenza surveillance and Ebola diagnostic capacity, the Rwandan NRL started COVID-19 testing by January 2020 for passengers from China. By March 2020, when the first COVID-19 positive was detected, the NRL tested 1000 samples (average 23 per day) which was manageable. However, detection of the first patient alerted the Rwandan Ministry of Health to initiate new measures including isolation, tracing and testing for contacts as well as expanding laboratory testing for passengers arriving from countries where COVID-19 were reported. These measures increased the COVID-19 samples tenfold. Samples increased to 1500 samples per day from April 2020 onward. To achieve such demand, a strong coordination including laboratory capacity rearrangement was employed. While the COVID-19 laboratory testing capacity was met, other services for TB and HIV were profoundly affected. The success to COVID-19 laboratory testing demand, challenges, disruption of others services, and future perceptive will be discussed.
Alice Kabanda

17:25 - 17:50: Q&A session

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