# Uptake and rollout of the World Health Organization-endorsed technologies for Tuberculosis diagnosis in Africa: a literature review of international evidence 2007-2021

## TL;DR

This paper reviews how quickly tuberculosis diagnostic technologies recommended by the WHO have been adopted and used in African countries from 2007 to 2021.

## Contribution

The study provides a comprehensive literature review on the adoption and rollout of WHO-endorsed TB diagnostic tools in the African region.

## Key findings

- Xpert MTB/RIF was the most studied diagnostic tool, followed by Line Probe Assay and MGIT.
- Only 24% of countries had published data on Lipoarabinomannan rollout.
- Adoption and rollout of TB diagnostic technologies in Africa have been slow.

## Abstract

The World Health Organization (WHO) has endorsed a range of diagnostic tuberculosis (TB) over the years. A little is documented about the uptake in the WHO African Region (WHO/FR).

We assessed the uptake of the endorsed diagnostic technologies for tuberculosis through a literature review.

We reviewed literature in French and English from PubMed, Google Scholar, and Embase for TB diagnostics endorsed by WHO between January 2007 and December 2017, extending to December 2021 for recent technologies. We included publications from the 47 countries in the WHO/AFR. Data were analyzed using PRISMA diagrams and STATA 14.0.

Out of 3,399 articles, 1,716 articles were screened, and 92 qualified for analysis. The majority of articles were on Xpert MTB/RIF (XPERT) 22 (47%), Line Probe Assay (LPA), 10 (21%), and Mycobacteria Growth Indicator Tube (MGIT) 9 (19%). For rollout, 11 (24%) of countries had publications on Lipoarabinomannan (LAM) and 16 (36%) on XPERT. The median years for uptake were 6 for MGIT, 5 for XPERT, and 2.5 for LPA. For the rollout, the median years for MGIT, LPA, and XPERT were 7, 6, and 5 respectively

Our study shows that the uptake and rollout are slow. Future studies should identify factors affecting rapid uptake and rollout.