Strengthening Lab Capacity to Save Lives: How MSH is Helping Ethiopia Eliminate TB

February 22, 2024

Strengthening Lab Capacity to Save Lives: How MSH is Helping Ethiopia Eliminate TB

Sitting in an outside courtyard at Yirgalem General Hospital brings back many memories for Getu—a husband, a father, and a survivor of tuberculosis (TB). “I remember when I first came here,” he says. “I noticed that I was very fatigued. I had a bad cough, and I was losing weight. But, at that time, I didn’t know much about TB, so I didn’t recognize the symptoms. I actually stayed at home feeling sick for two months before I eventually sought a doctor’s opinion.”

A lab technician at the Yirgalem General Hospital prepares GeneXpert samples for testing. Photo credit: Jennifer Gardella, MSH

Getu turned to Yirgalem General Hospital—located in Ethiopia’s Sidama Region, which bears one of the country’s highest TB caseloads—for care. That hospital partners with the USAID Eliminate TB Project, a five-year initiative implemented by Management Sciences for Health (MSH). Building on MSH’s contributions to Ethiopia’s TB control efforts over the past 15 years, the project aims to reduce TB incidence and mortality by improving the quality and sustainability of TB services in Ethiopia.

A key component of the USAID Eliminate TB Project’s approach is working to increase access to early TB diagnosis and treatment for patients. To do so, the project focuses on expanding and improving laboratory services by providing state-of-the-art GeneXpert machines to health facilities throughout the country and training laboratory technicians on their use. Through molecular testing, this sophisticated equipment delivers results in a matter of hours rather than the weeks needed to process microscopic tests, thereby minimizing backlogs and increasing efficiency at high TB burden facilities like Yirgalem General Hospital.

“Yearly, we are detecting more than 1,000 TB cases, and the GeneXpert machine has helped tremendously with sample processing,” says Mr. Temesgen Sermiso Lallamo, Yirgalem General Hospital’s Chief Executive Officer. “This advanced technology really cuts down on the time needed to perform these tests. They are also extremely accurate, so we can get patients appropriately diagnosed and on treatment much more quickly than before.” 

“I came here every month for six months to get my monthly doses of my medicines. During every checkup, they gave me counseling about good nutrition while recovering from TB and how to protect my family and others from catching it. Each month, I felt stronger…. I could feel that I was getting better.” 

Getu, TB survivor from Yirgalem, Sidama Region, Ethiopia

In this way, strengthening laboratory capacity by providing facilities with GeneXpert machines leads not only to better patient outcomes but also to reduced community transmission, making those machines an instrumental tool in the fight against TB. Since launching in 2020, the USAID Eliminate TB Project has helped deliver and install nearly 300 GeneXpert machines to health facilities in Ethiopia, bringing the total number of machines in the country to nearly 500. The project also provides on-the-job training, supportive supervision, and mentorship on TB diagnostics, including the use and maintenance of GeneXpert machines, to laboratory professionals, reaching more than 1,000 lab experts across Ethiopia over the last three years.

Upon his arrival at Yirgalem General Hospital, Getu was screened by the hospital’s triage team, which immediately sent him to get tested for TB based on his symptoms. Thanks to the rapid and precise diagnostic capabilities of the GeneXpert machine, Getu had his results within hours of his test: he was confirmed positive for TB. “I was started on medication right away, but I was fearful,” he says. “The doctor explained everything to me—what the disease is, what the treatment is and how to follow it, and how to take care of myself during the recovery. It made me feel a little bit less afraid.”

A doctor at the Yirgalem General Hospital demonstrates how GeneXpert machines are used. Photo credit: Jennifer Gardella, MSH

One of Getu’s doctors, Dr. Rediet Daniel, credits the USAID Eliminate TB Project with enhancing the hospital’s ability to provide quality patient care—with respect not only to laboratory capacity but to TB services writ large as well. “The USAID Eliminate TB Project is one of our main partners, especially for the drug-susceptible TB care,” says Dr. Rediet Daniel. “With the Sidama Regional Health Bureau, the project provides us with supportive supervision to help us identify improvements we can implement to improve the care we provide to patients.”  

To complement efforts to strengthen lab capacity at facilities like Yirgalem General Hospital, the USAID Eliminate TB project provides health workers with supportive supervision and ongoing mentorship across a wide range of topics pertaining to both the programmatic and clinical management of TB, including drug-resistant forms of the disease. “This regular mentorship is helpful—not just for this facility but for the entire catchment area,” Dr. Rediet Daniel explains. TB focal points from 40 facilities in Sidama come here every three months to attend these sessions. In this way, the project helps strengthen the capacity of TB care providers beyond this facility. It is very comprehensive.”

“Despite the challenges we face, the bottom line is that we are here to provide the best care to patients with the resources we have. The support we have received from the USAID Eliminate TB Project has been very important. It all comes down to keeping people healthy.”

Dr. Rediet Daniel, TB Focal Point, Yirgalem General Hospital
Getu outside Yirgalem General Hospital with Dr. Hitiya. Photo credit: Jennifer Gardella, MSH

Mr. Temesgen Sermiso Lallamo concurs. “Stories like these clearly demonstrate why this partnership with the USAID Eliminate TB Project has been so crucial for our hospital,” he emphasizes. “From the technical assistance on strengthening our laboratory services and case management capabilities to nutrition support for patients in treatment, the support has been huge. Without the involvement of this project, our diagnostic capacity would not be nearly as strong, and success stories like Getu’s might not happen.”

The USAID Eliminate TB Project’s impact extends far beyond Yirgalem General Hospital. The project provides direct support to bolster TB services at more than 170 hospitals, nearly 1,850 health centers, and around 8,650 health posts across seven regions, impacting the lives and health of countless people like Getu, who recently received some good news: after completing his treatment course, his subsequent tests showed no signs of active TB.

“When I received my diagnosis, it was such a big dilemma. I thought I will either get better, or perhaps I will not survive it,” he says. “When I learned that I was cured—what a feeling! I am very grateful for the treatment I received from these very skillful doctors. You might not be able to tell, but underneath this mask, I am smiling so big.”