COVID-19, tuberculosis and other common respiratory tract infections multi-directional testing at PHC in Viet Nam

What is the project?

In this project, Commune Health Stations (CHSs) in Viet Nam with no prior testing capacity, are empowered to independently detect and manage patients with COVID-19, Influenza A, B, RSV, and Streptococcus group A infections. Additionally, the project facilitates tuberculosis (TB) diagnosis through sample referral, making it more convenient for the community to access TB testing. At the district level, TB detection at District Health Center (DHCs) TB units are improved with the equipment of GeneXpert systems. The aim is to provide immediate access to healthcare services at the grassroot level, reducing the burden on higher levels of the healthcare system.

The project is implemented in two rural districts – Ung Hoa and Phuc Tho, Ha Noi province, Viet Nam, with 57 health facilities covering 55 communes and a population of about 524,000. CHSs actively participate in simultaneous screening for COVID-19, TB, and other common respiratory diseases in patients presenting respiratory symptoms. Patients with acute respiratory symptoms are screened for COVID-19, Influenza A, B, and RSV. Children aged under 15 with respiratory symptoms or having rash, lymphadenopathy or nausea and vomiting are tested for Streptococcus group A, in addition to COVID-19, Influenza A, B, and RSV testing. Those with TB symptoms and risks for TB have their sputum specimens collected and sent to DHCs’ TB units for TB testing using molecular GeneXpert system that is able to diagnose TB and multi-drug resistant TB. Detected TB cases are treated at the DHCs’s TB clinic, while drug-resistant TB cases are transferred to the provincial Hanoi Lung Hospital. This Xpert testing was set up at the 2 DHCs participating in the project, and a digital software (TBCOVID) was developed to support patients’ screening and testing, sample referring, data capture and reporting.

Why are we working on it?

Viet Nam, with a high TB burden, has been severely impacted by the COVID-19 pandemic. The pandemic has disrupted TB care, resulting in reduced doctor visits by individuals with TB symptoms and increased infection risks for healthcare staff. This has led to a significant decline in the notification rate of all forms of TB, including fewer microbiologically confirmed cases and increase of TB mortality rate. Furthermore, the COVID-19 pandemic and Long COVID-19 have triggered the activation of latent TB infections. The World Health Organization (WHO) emphasizes the importance of maintaining TB prevention and care during the pandemic and highlights bi-directional screening for TB and COVID-19 as a crucial measure.

What are its objectives?

The project aims to:

  • Improve the capacity of PHC facilities on multi-directional testing for COVID-19, TB, and other common respiratory tract infections
  • Demonstrate feasibility to implement integrated COVID-19, TB, and other common respiratory tract infection testing services at PHC facilities.
  • Demonstrate the impact of integrated COVID-19, TB, and other common respiratory tract infections testing services at PHC on TB testing.

What does it involve?

Specifically, the project is for:

  •  Establishing processes for screening, diagnostic testing, counseling, treatment, and patient management in case of detection.
  • Organizing on-site training programs for participating healthcare facilities.
  • Procuring and providing test kits, reagent, consumables and desktop computers.
  • Developing and deploying the TBCOVID software ( to capture epidemiology and clinical information of the test recipients and ensure the end-to-end data flow of the testing process up patient management, support sample referral and result reporting, as well as manage project activities.
  • Implementing diagnostic testing at primary healthcare facilities.
  • Providing technical support, monitoring, and evaluation, as well as communication materials (radio, leaflets and posters).
  • Assessing the feasibility and impact of the model to propose scaling-up plans.
  • Developing and piloting TBXpress Software for TB sample referral throughout all levels of TB diagnostic network.

What is the expected outcome?

The project sets out to achieve several anticipated outcomes, encompassing various aspects. These include the equipment of 2 GeneXpert systems and 5,000 Xpert cartridges, enabling 2 DHCs to utilize the systems and offer Xpert MTB/RIF testing for TB diagnosis. Additionally, the project involves supplying 57 desktop computers to 57 health facilities, along with 2 cool fridges and 2 vortex mixers specifically for the DHCs.

In terms of testing resources, the project aims to provide 20,000 COVID-19 Ag rapid tests and 20,000 Influenza A, B, and RSV Ag rapid tests to DHCs and CHSs. To effectively identify cases, the project aims to conduct a minimum of 15,000 COVID-19 Ag rapid tests for individuals displaying symptoms of COVID-19 and/or TB, 15,000 Influenza A, B, and RSV Ag rapid tests for individuals with symptoms associated with these infections, and 3,000 Streptococcus group A Ag rapid tests for individuals showing symptoms of Streptococcus group A infection.

Additionally, the project targets the testing of at least 3,000 individuals for TB using GeneXpert systems. The successful development, deployment, and integration of the TBCOVID software with VITIMES for patient and sample referral management are also key objectives. These anticipated outcomes, once realized within the project’s timeline, will significantly enhance testing and diagnostic capacities for COVID-19, TB, and other respiratory tract infections at primary healthcare facilities in Viet Nam.

What is the time scale?

The project is scheduled to run from July 2022 to September 2023.

Partners and Funding

The project is jointly undertaken by FIND Viet Nam and the Viet Nam National TB Program (VNTP), with funding from the Swiss Agency for Development and Cooperation.