The Impact of Xpert MTB/RIF Ultra and Stool-Based TB Diagnosis in Sierra Leone: A Retrospective Analysis of Routine GeneXpert Data, 2022–2023
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This study evaluates the implementation of the Xpert MTB/RIF Ultra diagnostic cartridge and the Simple One-Step (SOS) stool method across tuberculosis diagnostic sites in Sierra Leone between 2022 and 2023. The Ultra cartridge, designed to enhance sensitivity for Mycobacterium tuberculosis (MTB) and rifampicin resistance (RR-TB), was deployed nationally to improve case detection, especially among children and individuals unable to produce sputum. Analysis of routine GeneXpert data reveals increased diagnostic throughput, improved detection of drug-sensitive TB, and a modest decline in RR-TB prevalence. The integration of stool-based testing further expanded access to vulnerable populations. These findings underscore the transformative role of Ultra in strengthening TB control efforts in resource-limited settings.
