The August 2025 Rwenzori Regional Laboratory Bulletin reveals both challenges and achievements in the region’s lab services, highlighting urgent gaps in disease testing.
This edition focuses on performance indicators for July 2025, highlighting areas requiring urgent attention as well as positive trends in laboratory services. The Rwenzori region is supported by seven laboratory hubs: Kyegegwa, Kyenjojo, Fort Portal, Bundibugyo, Kagando, Mt. St Mary’s, and Rukunyu. These hubs facilitate sample and result transport to testing laboratories through 15 hub riders and two NHLDS sample transporters, ensuring timely delivery and monitoring of critical health data.
A key concern identified in July 2025 was the suboptimal utilization of GeneXpert machines for Mycobacterium tuberculosis (MTB) testing, which stood at only 45% regionally, far below the national target of 95%. Sites such as Ntara (26%), Padre Pio (23%), and Nyahuka (18%) recorded particularly low usage, while the regional GeneXpert error rate reached 6%, exceeding the 5% benchmark.
Bundibugyo and Bunyangabu districts reported error rates above 10%, largely due to unreliable power backup systems and operational inefficiencies. The bulletin flagged GeneXpert utilization as a “Significant Negative change” for the month.
Viral Load Turn Around Time (VL TAT) also exceeded national targets, averaging 16 days against a 14-day benchmark. Delays affected 71% of the hubs and were linked to extended transit times from peripheral sites to the National Health Laboratory and Diagnostic Services (NHLDS) and the ongoing transition to the Health Information Exchange (HIE) system. Despite this, VL sample rejection rates remained low at 0.6%, although Bundibugyo, Bunyangabu, and Ntoroko districts recorded rates above 1%, mainly due to poor sample quality.
Early Infant Diagnosis (EID) testing at the 22 POC sites accounted for only 26% of regional samples (324 out of 1,264), reflecting the continued reliance on centralized testing at the Central Public Health Laboratories.
Encouragingly, positivity rates at POC sites for the first PCR were 43%, demonstrating the critical role of point-of-care testing in identifying and managing infant infections early.
Microbiology services at Fort Portal Regional Referral Hospital Laboratory (RRHL) remained active, with 126 clients (60 males, 66 females) receiving culture and sensitivity tests. Out-patient samples accounted for 44%, while pediatric samples represented 13%. Analysis revealed antimicrobial growth in 44% of tested samples, with E. coli (9.5%), mixed bacterial species (19.8%), and Staphylococcus aureus (4.8%) being the most common isolates.
Sample logistics showed some improvement, with 86% of the seven hubs completing 100% of spoke-visits, ensuring consistent engagement with peripheral sites. The Bundibugyo hub fell short due to poor network connectivity in Ntoroko district. Overall, 4,546 samples were tracked through the hub system in July, including 73% Viral Load samples, 18% GeneXpert, 6% EID-POC, and 1% surveillance samples (covering Monkeypox, VHF, and Anthrax).
In summary, the bulletin reflects mixed progress: microbiology sample volume and accreditation sustenance showed significant positive changes, while GeneXpert utilization and spoke visits registered significant negative changes. Other indicators, including GeneXpert error rate, VL plasma coverage, VL TAT, and VL sample rejection, maintained performance but still require attention.
Data for the bulletin was compiled from DHIS2, NHLDS hub module, ALIS, ResTrack, and dashboards from CPHL and Fort Portal RRHL. The report underscores the need for continued investment in training, logistics, and system strengthening to ensure timely, accurate laboratory services that are essential for disease control and public health decision-making across the Rwenzori region.
