Transforming TB Diagnosis in Nigeria: Truenat Initiative, Says FG

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The Federal Government of Nigeria has initiated the Truenat programme to address the challenges posed by tuberculosis (TB) diagnosis in the country.

The director of public health at the Federal Ministry of Health and Social Welfare, Dr. Anyaike Chukwuma has highlighted the importance of this initiative, particularly in hard-to-reach areas where TB diagnosis remains a pressing concern.

The Truenat Initiative is supported by the Stop TB Partnership and USAID’s introducing New Tools Project (iNTP) and it focuses on deploying Truenat systems in peripheral facilities across Nigeria. This strategic approach aims to bring molecular testing for TB closer to the communities most in need, thereby improving access to rapid and accurate diagnosis.

Chukwuma has stated that with the introduction of Truenat, a rapid molecular testing system, the country has marked a significant milestone in the fight against TB. Nigeria has one of the highest burdens of TB in Africa, contributing significantly to the global TB burden. By leveraging innovative diagnostic technologies and strengthening diagnostic capabilities at the grassroots level, the government aims to enhance TB case detection and ultimately reduce the burden of the disease nationwide.

However, the country faces challenges in accurately diagnosing TB, with a considerable gap between estimated TB incidence and reported diagnoses. Access to rapid molecular testing has been limited, hindering timely diagnosis and treatment initiation.

The Truenat Initiative underscores the government’s commitment to addressing the TB epidemic comprehensively, with a focus on improving diagnosis, treatment and overall patient care. Through collaborative efforts with international partners and local stakeholders, the country is poised to transform TB diagnosis and make significant strides towards ending the TB epidemic in the country. The initiative aims to bring molecular testing to hard-to-reach populations and improve TB diagnosis rates.

According to Chukwuma, the Truenat systems have demonstrated impressive results, with over 100,000 samples tested between November 2021 and September 2023. The introduction of Truenat led to a significant increase in access to rapid molecular diagnostics, with a 100 per cent increase in the number of people tested with a WHO-recommended molecular diagnostic in supported facilities.

Operational research conducted during the implementation phase highlighted the feasibility and acceptability of Truenat among healthcare workers. Challenges such as equipment maintenance and errors were addressed through comprehensive training and technical support mechanisms. Additionally, engagement with key stakeholders and demand creation strategies were crucial in ensuring the success of the initiative.

Chukwuma has stated that the positive outcomes of the Truenat Initiative have paved the way for sustainability and expansion plans. Efforts are underway to increase the size of the Truenat fleet in the country, with support from private donors and inclusion in funding applications. With continued collaboration and investment, the country is poised to make significant strides in its TB control efforts.

Nigeria has the largest burden of TB in Africa and is one of eight countries contributing to two-thirds of the global burden of TB. Furthermore, the country is one of the five countries contributing to more than 50 per cent of the global gap between the estimated TB incidence and the reported number of people newly diagnosed with TB. According to estimates by the World Health Organisation (WHO), 41 per cent of people with TB in 2022 went without a diagnosis or were not accounted for in national data. One of the main factors contributing to the country’s low detection rate for TB is the lack of access to rapid molecular testing: only 68 per cent of people with TB undergo testing with a rapid molecular test at the time of diagnosis.

Racheal Abujah
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