A step forward

Bindu Shajan Perappadan
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Tuberculosis screening is setto become cheaper and faster with subsidised rapid diagnostic cartridges

Tough fight:Better diagnostics for TB.Photo: K. Ganesan
Tough fight:Better diagnostics for TB.Photo: K. Ganesan

Tuberculosis (TB) diagnosis has, over the years, been a very time consuming and expensive process, which sometimes cost the patients dear. However,it would soon become relatively cheaper and faster due to the united effort of a group of U.S.-based organisations.

Helping developing countries in their battle against TB, the United States President’s Emergency Plan for AIDS Relief (PEPFAR), the United States Agency for International Development (USAID), UNITAID, and the Bill & Melinda Gates Foundation recently announced an agreement that will significantly reduce the cost of a new, highly accurate, rapid diagnostic test for TB in 145 high-burden and developing countries.

Funds provided by this partnership will reduce the cost of Xpert MTB/RIF cartridges (used for diagnosing TB) from $16.86 to $9.98 — a price which will not increase until 2022.  “The high unit cost of Xpert® MTB/RIF cartridges produced by the medical device manufacturer Cepheid has proven a barrier to their introduction and widespread use in low and middle-income countries. The new agreement will immediately reduce the cost of the cartridges by more than 40 per cent,’’ said the organisations.

Previously the only method used in most laboratories in developing countries was smear microscopy, which is particularly insensitive for diagnosing TB in patients who are co-infected with HIV. It also does not help clinicians detect the presence of drug-resistant strains of TB.

Cepheid’s GeneXpert is a molecular diagnostic system that can detect TB in patients co-infected with HIV and the disease’s resistance to the antibiotic rifampicin — a widely accepted indicator of the presence of multi-drug resistant TB — in less than two hours.  

The test can be done outside conventional laboratories also because it is self-contained and does not require specialised training.

The capacity of the Xpert MTB/RIF has the potential to improve TB diagnosis and treatment in rural clinical settings. Research suggests that the incremental scale up of GeneXpert in countries with high TB burdens could allow for the rapid diagnosis of 700,000 cases of TB disease; and save health systems in low and middle-income countries more than $18 million in direct health costs, claimed the organisations.

Welcoming the announcement, Revised National TB Control Programme Employees Association president R.M. Tripathi said, “Early diagnosis is the key to win the battle against TB. We have been handling several cases where non-compliance with medicines has caused patients to develop resistant TB, or when combined with HIV the disease becomes very tough to fight. The easy and early diagnosis, we hope, will go a long way in benefiting patients and will also ensure better work environment and reduce risk for us employees of the programme who deal with TB patients throughout our working life.”



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