The current South African National guidelines following Xpert MTB/RIF (Xpert) introduction for TB diagnosis advocate for treating all Xpert positive and rifampicin resistant patients as MDR-TB cases while awaiting confirmation by phenotypic or genotypic drug susceptibility testing. This study evaluates how the Xpert has influenced the diagnosis and management of drug resistant TB in the highest burdened district of KwaZulu-Natal Province.

Despite the rapidity of the Xpert results, only about 70% of patients had been initiated treatment at one month. Therefore there is a definite need to improve the health systems in order to improve on these delays. A few lessons have been learnt following the introduction of Xpert. Introducing a new test requires proper preparation and training of those involved in order to ensure compliance with the stipulated guidelines.

This study emphasizes the importance of complying with the established algorithm in confirming all Xpert positives and rifampicin resistant cases so as to ensure proper management of these patients.

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