The World Health Organization in 2017 stated that of 44,000 TB cases in Uganda, 12,000 died amounting to a 25% mortality rate. In many African and Asian Nations, the average turnaround from the time of sample collection to receiving results is one week which leads to the delayed linkage of positive patients to care. The turnaround time of testing in a rural setting is much worse than average since most of the GeneXpert machines are based in major hospitals. With a majority of the population living in rural settings, this delay puts the majority of the general population at risk of contracting TB.
In general, specialized medical testing equipment is expensive and thus only available at high-end laboratories that can afford the upfront capital expenditure. For example, there are only about 240 specialized TB testing machines (GeneXpert) in Uganda expected to serve over 40 million Ugandans.
Health facilities that cannot afford these machines collect patient samples and send them to the high-end laboratories. After processing, test results are sent back upon which appropriate action is taken by the health facility.
Currently, the National Sample and Result Transportation Network collects and sends samples to testing sites which are usually not more than 2 per district (in the case of TB). The results are sent back using the same means.
Motorbike breakdowns during sample
and result transportation
Weather interferences, for example, in wet seasons, transporters may fail to deliver results and collect samples from all health facilities within a district
Results often go missing at testing sites
due to poor data management
Human personnel failures/errors