Increasing TB diagnosis through use of Truenat technology

Truenat is a molecular diagnostic equipment developed by Molbio Diagnostics, Goa, India. It uses portable, battery operated devices to rapidly detect Mycobacterium tuberculosis complex bacteria (MTBC) and rifampicin resistance. The system involves two main devices;

The Trueprep™ AUTO Sample Prep Device and the Truelab™ Real Time micro PCR Analyzer. Truenat is seen as a promising new TB diagnostic tool since it’s more sensitive and specific than microscopy, has minimal infrastructure requirements and can be used as near-POC and results are rapidly available allowing for same-day diagnosis and can detect RIF resistance within two hours.
With funding from USAID, SRL Uganda has recently installed 38 Truenat devices to support in diagnosis of TB and drug resistant TB across the county. This is to further increase access to early, rapid and quality TB diagnosis through use of WHO recommended molecular diagnostic tools.

DistrictHealth facility
Katakwi DistrictToroma HC IV
Terego DistrictOmugo HC IV
Yumbe DistrictMidigo HC IV
Yumbe DistrictYumbe HC IV
AmudatKarita HCIV
Rukiga DistrictKamwezi HC IV
Kasese DistrictRukoki HC IV
Buliisa DistrictBiiso HCIV
Kabarole DistrictBukuku HC IV
KakumiroKakumiro HCIV
Kabarole DistrictRutete HCIV
Kisoro DistrictRubuguri HC IV
Tororo DistrictMukuju HC IV
Tororo DistrictNagongera HC IV
Manafwa DistrictBugobero HC IV
Mbale DistrictBufumbo HC IV
Mbale DistrictNamatala HC IV
Sironko DistrictBuwasa HC IV
Butaleja DistrictNabiganda HC IV
Nakaseke DistrictNgoma HCIV
Lwengo DistrictKiwangala HC IV
Kalangala DistrictBukasa HC IV
Kalaki DistrictLwala hospital
SheemaShuuku HCIV
Ibanda DistrictIshongororo HC IV
Isingiro DistrictRwekubo HC IV
KotidoKanawat HC III
Kamuli DistrictKagumba HC IV
Bugiri DistrictNankoma HC IV
Kamuli DistrictNamwendwa HC IV
Lira DistrictAmach HC IV
Amuru DistrictKaladima HCIII
Wakiso DistrictKabubbu HCIV
Wakiso DistrictBweyogerere HCIIII
Nakaseke DistrictSemuto HC IV
KampalaNational TB Reference Laboratory
Luwero DistrictNyimbwa HC IV
Wakiso DistrictBuwambo HC IV

Use of TB-LAMP as a replacement for microscopy

Loop mediated Isothermal amplification (LAMP) is a unique temperature independent technique for amplifying DNA that was developed by Eiken Chemical Company (Totyo, Japan). It is simple to use, providing a visual display. Additionally, the technique is robust and can be used at peripheral health facilities where microscopy is performed. TB-LAMP is a manual assay that requires 1 hour to perform and results can be read by naked eye under UV light. TB LAMP requires minimal infrastructure and Biosafety requirements that is similar to sputum smear microscopy. Uganda is implementing TB-LAMP in 16 health facilities across the country to increase capacity for TB diagnosis. It is also envisaged that due to the high throughput of TB-LAMP (maximum capacity of 70 samples per day), this tool will be important in supporting TB testing in seasons of TB campaign which generate high volumes of samples.

Table 2: List of TB-LAMP facilities

JinjaJinja Municipal HCIII
MbaleNakaloke HCIII
MorotoNadugent HCIV
NakapiripiritiNamalu HCIII
NapakLopei HCIII
NabiratukLolachat HCIII
SorotiPrincess Diana HCIV
AruaSt. Assumpta HCIII
GuluLayibi Techo HCIII
LiraP.A.G HCIV
HoimaAzur HCIV
KaseseKasese Municipal HCIV
MbararaMbarara Municipal HCIV
KabaleRushoroza HCIV
MasakaKitovu Hospital
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