The National Tuberculosis Reference Laboratory (NTRL), through its Learning and Development Section (LDS), capacitated 37 laboratory personnel from 15 identified facilities to perform Xpert MTB/XDR testing in their respective Rapid TB Diagnostic Laboratory (RTDL) last March 14-15, 2023 via Zoom.

The Training on Xpert MTB/XDR utilized a distant learning approach composed of two half-day didactics sessions. NTRL-LDS led the sessions covering the fundamentals on biosafety practices, specimen handling, troubleshooting and maintenance. Supplemental modules covering the principles behind Xpert MTB/XDR assay Technology and Processing and Results Interpretation were also discussed.

According to NTRL-LDS Xpert MTB Training Point Person Ms. Arcdel Urcia, all the participants passed the training with an average posttest score of 96.28% – a marked improvement from their average pretest score of only 47.36%.

“Since the Philippines is a high-burden country for multi-drug resistant TB, the expansion of XDR testing will fast-track the genotypic drug susceptibility (DST) for second-line drugs,” explained Ms. Urcia.

Currently, there are only six (6) facilities who perform the testing nationwide. By the end of the year, NTRL envisions that the technology has already been decentralized with a total of 21 RTDLs equipped with the platform for Xpert MTB/XDR testing, a 10-color GeneXpert machine.

Xpert MTB/XDR is the first low-complexity nucleic acid amplification test (NAAT) that detects the presence of Mycobacterium tuberculosis (MTB) and resistance to first- and second-line anti-TB drugs.

With the endorsement from the World Health Organization (WHO), the technology is now integrated into the TB diagnostic algorithm as a follow-on diagnostic for additional drug resistance and an alternative to Line Probe Assay (LPA).

In comparison to LPA, the use of Xpert MTB/XDR entails simple infrastructure and low biosafety requirements and releases results within 90 minutes. The technology intends to provide early diagnosis of TB and improve access to rapid anti-TB drug susceptibility testing (DST).

The additional 15 RTDLs identified to implement the test include the Cagayan Valley Regional TB Culture Laboratory; Baguio General Hospital and Medical Center; Jose B. Lingad Memorial Regional Hospital; Tarlac Provincial Hospital; Lung Center of the Philippines; Batangas Medical Center; General Emilio Aguinaldo Memorial Hospital; Ospital ng Palawan; Bicol – South Luzon Sub National Reference Laboratory; Cebu TB Reference Laboratory; Eastern Visayas Medical Center; Northern Mindanao TB Reference Laboratory; Cotabato Regional Medical Center; SOCCSKSARGEN General Hospital; and Caraga Regional TB Culture Laboratory.