The NPP supports various HCT campaigns that have been hosted by DoH, these include: World TB Day 2012, World Aids Day 2012, Farming sector campaign (Brits), Public Servants campaign (Union Buildings Pretoria), among others. At each campaign, CD4 and TB GeneXpert testing services have been available by the NHLS.
World TB Day 2012
World TB day was commemorated by the National Department of Health on Saturday 24th March at the KDC West Goldfields Mining Complex, Carltonville. The global theme was “Stop TB in my lifetime”, with a South African sub-theme of “Zero infections, deaths, stigma & discrimination from TB & HIV in my Lifetime”.
In 2010/11, approximately 11% of the S.A. gold mining sector’s miners were estimated to be infected with TB, compared to an industry average of 5%. This sector also has some of the most limited access to TB and HIV services. On World TB Day, the Deputy President, Minister of Health, Premier, MEC and many other dignitaries including prominent health activists were present and discussed their proposed year long focus on the gold mines for TB screening as well as launching the implementation plans for the National Strategy Plan.
The NHLS teamed up with Aurum Health and Right-To-Care for the screening and testing of miners and community members for TB and HIV at the event. Aurum Health provided five “mobile labs” into which the NHLS National Priority Programmes team, together with the kind assistance of Progen, placed 10 x GeneXpert®-XVI-site-instruments for TB testing. During the day, a total of 520 people were tested for TB using the rapid and sensitive Xpert® MTB/Rif assay, which is currently being rolled out by the NHLS nationwide in a phased manner.
Laboratory CD4 testing on the move
Laboratory CD4 testing went mobile on National World TB day, as part of the HCT drive during the TB testing campaign. The National Priority Programme CD4 team, with the generous assistance of Beckman Coulter, managed to secure a local mobile unit into which two XL flow cytometers were housed. This is the instrument currently used in 35 NHLS CD4 testing facilities. They were chosen for their medium throughput capacity of 150 samples/instrument/8 hour day (n=300 in total).
The instruments were successfully installed, validated and verified for accuracy on the day preceding events, with confirmatory quality control measures passed on the day of testing. In total, 166 patients were tested for an absolute CD4 count and although results were not released to patients on the day, 60% of patients tested qualified for initiation of treatment based on a CD4 count of <350cells/µl. Test results were released to local coordinators for follow up of patients. Although there are various mobile units deployed for HCT/VCT/TB screening throughout South Africa, this is the first time that a reference laboratory CD4 test method has been successfully transferred into a mobile unit that is spacious enough to house both equipment and operators. This opens up new possibilities for service delivery in areas where distance to the nearest CD4 testing laboratory (>250km/3hours drive) delays CD4 result reporting.
The mobile testing facility further has the potential to provide an “all-in-one” screening capacity for initiation of anti-retroviral therapy through customized setup with additional laboratory equipment for TB, basic haematology and chemistry screening tests.
The National Priority Programmes team, led by Professor Wendy Stevens, was responsible for successfully coordinating both TB and CD4 testing performed on the day. A special mention must be made of Mr. Floyd Olsen who led the related logistics from inception. Furthermore, a thank you must go to all the NHLS staff who volunteered their services on the day-their professionalism and skill was a testimony to the excellent core of staff that are based within the organisation.
The NHLS CEO, Mr Sagie Pillay (pictured centre) with Prof Wendy Stevens (pictured left) and the proud NHLS volunteers from laboratories from surrounding areas.
Overall, the day was a great success and certainly demonstrated what can be possible, given the enthusiasm of NHLS staff. With ongoing hard work and commitment by all parties, the scourge of TB which has plagued us for centuries globally and especially in South Africa with the rise of the HIV/AIDS epidemic, may indeed be brought to a stop in our lifetimes.