{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T18:14:42Z","timestamp":1778523282216,"version":"3.51.4"},"reference-count":14,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJTLD Open"],"accepted":{"date-parts":[[2026,1,7]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"SUMMARY<\/jats:title>\n \n BACKGROUND<\/jats:title>\n Although Xpert MTB\/RIF Ultra (Ultra) has revolutionised TB diagnosis, operational challenges can significantly undermine its benefits. This study examined operational experiences and challenges associated with Ultra use across Rwanda\u2019s health care settings.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n We conducted a cross-sectional survey across 53 GeneXpert testing centres between October and December 2024. The survey addressed machine usage, sample processing timelines, and technical challenges through structured interviews with laboratory managers and operators.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n While 41% of sites processed samples within 5 h, 55% experienced delays exceeding 24 h due to high volumes and limited capacity. Four labs (8%) reported significant delays (>8 h) processing sputum with sample reagent. Modules failures occurred in 81% of facilities within the preceding year, with most experiencing infrequent failures and one site experiencing more than six annually. Connectivity issues with internet and\/or \u2018DataToCare\u2019 affected 17% of sites, causing workflow delays. Equipment capacity constraints were identified in 30% of sites, particularly affecting facilities managing dual TB and HIV\/hepatitis testing, while 9% reported staffing shortages.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n Despite successful nationwide deployment, operational challenges limit Ultra\u2019s full potential. Strategic machine allocation, upgraded connectivity, and improved preventive maintenance represent key intervention areas. These findings offer valuable insights optimising rapid molecular diagnostic use in similar settings.<\/jats:p>\n <\/jats:sec>","DOI":"10.5588\/ijtldopen.25.0630","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T17:52:07Z","timestamp":1778521927000},"page":"298-304","source":"Crossref","is-referenced-by-count":0,"title":["Key operational challenges at a programmatic level to achieve optimal use of the GeneXpert platform"],"prefix":"10.5588","volume":"3","author":[{"given":"I.","family":"Cuella-Martin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Hakizayezu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Kamanzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.M.","family":"Habimana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Migambi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.C.","family":"de Jong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Rigouts","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.C.S.","family":"Ngabonziza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3554","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"key":"2026051110520259000_3.5.298.1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01463-09"},{"key":"2026051110520259000_3.5.298.2","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.00812-17"},{"key":"2026051110520259000_3.5.298.3","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00543-2016"},{"key":"2026051110520259000_3.5.298.4","unstructured":"World Health Organization . Xpert MTB\/RIF implementation manual: technical and operational \u2018how-to\u2019; practical considerations. Geneva: WHO, 2014."},{"key":"2026051110520259000_3.5.298.5","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofw068"},{"key":"2026051110520259000_3.5.298.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2024-018700"},{"issue":"11","key":"2026051110520259000_3.5.298.7","doi-asserted-by":"crossref","first-page":"e0279677","DOI":"10.1371\/journal.pone.0279677","article-title":"Optimizing diagnostic networks to increase patient access to TB diagnostic services: development of the diagnostic network optimization (DNO) approach and learnings from its application in Kenya, India and the Philippines","volume":"18","author":"Albert","year":"2023","journal-title":"PLoS One"},{"key":"2026051110520259000_3.5.298.8","unstructured":"Rwanda Biomedical Centre. Tuberculosis and other respiratory communicable diseases division annual report 2020-2021. Rwanda Biomedical Centre, 2021. https:\/\/www.ccm.rw\/fileadmin\/user_upload\/Annual%20report%20TB%20%20ORD%202020%202021.pdf."},{"key":"2026051110520259000_3.5.298.9","first-page":"ciaf132","article-title":"Paucibacillary tuberculosis drives the low positive predictive value of Xpert MTB\/RIF ultra for rifampicin resistance detection in low-prevalence settings","volume":"22","author":"Cuella-Martin","year":"2025","journal-title":"Clin Infect Dis"},{"key":"2026051110520259000_3.5.298.10","unstructured":"Rwanda Biomedical Centre. Tuberculosis and other respiratory communicable diseases division annual report 2023-2024. Rwanda Biomedical Centre, 2024. https:\/\/www.rbc.gov.rw\/fileadmin\/user_upload\/report_2024\/TB\/TBORD_annual_report_2023-2024.pdf."},{"key":"2026051110520259000_3.5.298.11","unstructured":"Cepheid . Xpert MTB\/RIF ultra. Instructions for use. Cepheid, 2023. https:\/\/infomine.cepheid.com\/sites\/default\/files\/2024-01\/302-5776%20Rev.%20D%20IFU%20MTB.RIF%20Ultra%20ENGLISH%20MII.pdf."},{"key":"2026051110520259000_3.5.298.12","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01053-10"},{"issue":"1","key":"2026051110520259000_3.5.298.13","first-page":"27","article-title":"Can the high sensitivity of Xpert MTB\/RIF ultra be harnessed to save cartridge costs? Results from a pooled sputum evaluation in Cambodia","volume":"5","author":"Chry","year":"2020","journal-title":"Trop Med Infect Dis"},{"issue":"3","key":"2026051110520259000_3.5.298.14","doi-asserted-by":"crossref","first-page":"719","DOI":"10.3201\/eid2703.204090","article-title":"Systematic review of pooling sputum as an efficient method for Xpert MTB\/RIF tuberculosis testing during the COVID-19 pandemic","volume":"27","author":"Cuevas","year":"2021","journal-title":"Emerg Infect Dis"}],"container-title":["IJTLD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.5588\/ijtldopen.25.0630","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T17:52:09Z","timestamp":1778521929000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.theunion.org\/lookup\/doi\/10.5588\/ijtldopen.25.0630"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":14,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,1]]},"published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.5588\/ijtldopen.25.0630"],"URL":"https:\/\/doi.org\/10.5588\/ijtldopen.25.0630","relation":{},"ISSN":["3005-7590"],"issn-type":[{"value":"3005-7590","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}