Top Scoops

Book Reviews | Gordon Campbell | Scoop News | Wellington Scoop | Community Scoop | Search

 

Hopes rest on a new rapid diagnostic test for tuberculosis

Hopes rest on a new rapid diagnostic test for tuberculosis (TB)

Bobby Ramakant - CNS

One of the best chances of stemming the tide of tuberculosis (TB) epidemic in low- and middle- income countries is to thwart the transmission cycle – by diagnosing TB early, and treating it successfully without delay. The microscope has been around since 1882 as the key standard TB diagnostic tool, and with low sensitivity (50-60%) and other challenges in detecting TB in varying conditions and co-morbidities, it is clear that it is high time we use better, more effective and efficient tools to accurately detect TB, and neither mis-diagnose nor miss TB diagnosis in myriad settings.

This was a clear thought emerging out of the 'International Symposium on Tuberculosis Diagnostics: Innovating to make an impact' (ITBS 2010), organized by the International Centre for Genetic Engineering and Biotechnology (ICGEB) in New Delhi, India (16-17 December 2010) with support from the Aeras Global TB Vaccine Foundation, Bill and Melinda Gates Foundation and Foundation for Innovative New Diagnostics (FIND).

Although high-income countries have moved on to using better and modern diagnostic tools, many low- and middle- income countries still rely principally on sputum smear microscopy.

One of the diagnostic tools that the World Health Organization (WHO) recently endorsed is a fully automated Nucleic Acid Amplification Test (NAAT) - Xpert ® MTB/RIF - a new and novel rapid test for TB, especially relevant in high TB burden countries. According to the WHO, the test could revolutionize TB care and control by providing an accurate diagnosis for many patients in about 100 minutes, compared to current tests that can take up to three months to have results. This WHO endorsement of the NAAT has come after 18 months of rigorous assessment of its field effectiveness in the early diagnosis of TB, as well as multidrug-resistant TB (MDR-TB) and TB complicated by HIV infection, which are more difficult to diagnose.

THREE-FOLD INCREASE IN DIAGNOSING DRUG-RESISTANT TB POSSIBLE
----------------
According to the WHO, evidence to date indicates that implementation of this test could result in a three-fold increase in the diagnosis of patients with drug-resistant TB and a doubling in the number of HIV-associated TB cases diagnosed in areas with high rates of TB and HIV.

But this new 'while you wait' test incorporates modern DNA technology that can be used outside of conventional laboratories. It also benefits from being fully automated and therefore easy and safe to use.

WHO is now calling for the fully automated NAAT to be rolled out under clearly defined conditions and as part of national plans for TB and MDR-TB care and control. Policy and operational guidance are also being issued based on findings from a series of expert reviews and a global consultation held last week in Geneva. The consultation was attended by more than a hundred representatives from national programmes, development aid agencies and international partners.

75% REDUCTION IN PRICE FOR COUNTRIES MOST AFFECTED BY TB
----------------
Affordability has been a key concern in the assessment process. Co-developer FIND (the Foundation for Innovative and New Diagnostics) announced recently it has negotiated with the manufacturer, Cepheid, a 75% reduction in the price for countries most affected by TB, compared to the current market price. Preferential pricing will be granted to 116 low- and middle- income countries where TB is endemic, with additional reduction in price once there is significant volume of demand.

"There has been a strong commitment to remove any obstacles, including financial barriers, that could prevent the successful roll-out of this new technology," said Dr Giorgio Roscigno, FIND's Chief Executive Officer in a WHO communique. "For the first time in TB control, we are enabling access to state-of-the-art technology simultaneously in low, middle and high income countries. The technology also allows testing of other diseases, which should further increase efficiency."

WHO is also releasing recommendations and guidance for countries to incorporate this test in their programmes. This includes testing protocols (or algorithms) to optimize the use and benefits of the new technology in those persons where it is needed most.

Though there have been major improvements in TB care and control, tuberculosis killed an estimated 1.7 million people in 2009 and 9.4 million people developed active TB last year.

*************

Bobby Ramakant – CNS (The author is the Director of CNS Stop-TB Initiative and a World Health Organization (WHO) Director-General’s WNTD Awardee 2008. He writes extensively on health and development for Citizen News Service (CNS). Email: bobby@citizen-news.org, website: www.citizen-news.org )

© Scoop Media

 
 
 
Top Scoops Headlines

 

Gordon Campbell On Labour’s Timidity:

What an odd post-Cabinet press conference that was yesterday, from PM Jacinda Ardern and Finance Minister Grant Robertson ... More>>

Gordon Campbell: On The Prevailing Media Narratives About The Govt Coalition

The media reports the facts…. but that’s not the end of it, and nor should it be. It also marshals those facts and creates a story from them, usually one with a moral that’s implied or explicit. After six months though, it is still unclear just what the dominant media narrative is of the coalition government. Is it Idealistic But Impractical? Is its Heart in the Right Place, but is it Taking On Too Much? Is the coalition proving to be Fractious And Unstable, or is it Surprisingly Adept at Keeping Its Inherent Rifts Out of the Public Eye? More>>

RNZ Explainer: Why You Should Care About Cambridge Analytica

Facebook's shares have lost billions of dollars in value after something to do with data used by Cambridge Analytica. Confused? Here's what it means, and what could come next...More>>


Gordon Campbell: On The (Looming) Nurses’ Strike

It is (almost) possible to feel a bit sorry for the DHB negotiators engaged in the current nurses pay round. Come next Monday there’s every sign that nurses will resoundingly reject the pay offer the DHBs have put on the table, as being totally inadequate...More>>

Gordon Campbell: On A Trade War With China

As things currently stand, the White House has NOT included New Zealand on its list of allies whose steel and aluminium exports to the US will be exempted from US President Donald Trump’s recent hike in tariffs. More>>

Gordon Campbell: On Credibility In Politics

Credibility is always such a fickle, unstable element in politics. You know it when you see it, though. More>>

Video And Report: Cory Doctorow Talks Machine Learning And Big Data

International internet and digital technology commentator Cory Doctorow talked about machine learning and big data at the Privacy Commissioner’s PrivacyLive event on 13 March 2018 in Wellington. More>>