CDC Partners with Vietnam to Fight Tuberculosis

Double X partnership triples TB diagnoses

CDC Vietnam helped triple tuberculosis (TB) diagnoses and improve access to life-saving treatment for people living with HIV (PLHIV) through a partnership between TB and HIV programs. In 2020, the Vietnam National Tuberculosis Program (NTP) endorsed two key approaches to end TB: active TB detection and dormant TB screening and treatment. People with active TB infection typically show symptoms of the disease, while people with dormant cases do not show any symptoms. PLHIV are more likely than others to become sick with TB. Early TB diagnosis and treatment among high-risk, vulnerable groups, including PLHIV, is crucial but continues to be a challenge in Vietnam. TB and HIV services lack  strong coordination, and aren’t coordinated with other healthcare services. To reach this high-risk population, CDC Vietnam and partners employed the “Double X” strategy of enhanced case finding using chest X-Ray (CXR) and the molecular diagnostic assay Xpert MTB/RIF to diagnose TB.

Partnering with the NTP and local TB and HIV programs, CDC Vietnam implemented the Double X diagnostic strategy among PLHIV in three Vietnamese provinces from July to September 2020. Across these provinces, 6,389 PLHIV were screened for TB symptoms using the new Double X strategy of the PLHIV screened, 1,479 (23%) had a TB-like symptom. The Double X strategy more than tripled the number of TB cases found compared to passive TB detection strategy. Screening and diagnosing TB among patients ensured early linkage to treatment, and increased doctor’s confidence to prescribe TB treatment when there aren’t any symptoms. The results of this program were shared across Vietnam, and helped inform the revision of Vietnam’s national guidelines for diagnosing and treating TB among PLHIV.

CDC helps laboratories maintain high quality assurance for tuberculosis testing

Participants in the Xpert MTB/RIF quality assurance workshop in Hanoi. November 2020.

Ensuring high-quality tuberculosis (TB) diagnosis is critical in finding and treating people affected by the disease, ending transmission, and ultimately reducing TB incidence and mortality. In November 2020, CDC Vietnam helped organize and deliver two-day workshops in more than 220 laboratories nationwide on quality assurance for tuberculosis (TB) diagnostic tests. CDC Vietnam worked closely with the National TB Reference Laboratory (NRL) to develop the agenda for the workshop and assisted with data review and interpretation for presentations and discussions. The workshop aimed to improve quality assurance for the Xpert MTB/RIF diagnostic test for TB.  Participants reviewed the performance at their respective sites for key quality indicators, and focused on practical implementation issues, such as troubleshooting, maintenance, and data use and reporting. Since 2013, CDC Vietnam supported the NRL to establish the External Quality Assurance (EQA) program for the Xpert MTB/RIF diagnostic test across Vietnam. Vietnam is now expanding this knowledge to other countries in the region with CDC support.