July 2, 2008

Drug-Resistant TB to Be Diagnosed in Just 2 Days

By Kounteya Sinha

NEW DELHI: Diagnosing multi drug-resistant tuberculosis (MDR-TB) will now take just two days' time.

In a major announcement on Monday, the World Health Organisation decided to make widely available a path-breaking rapid molecular diagnostic tool that will generate TB test results in two days flat.

Currently, standard tests take up to three months. This is why only 2% of MDR-TB cases worldwide are being

diagnosed and treated appropriately.

Speaking to TOI from Geneva, Stop TB Partnership's team leader for lab strengthening Dr Karin Weier said the new DNA-based rapid test will increase the number of MDR-TB cases diagnosed by at least seven-fold over the next four years to 15%.

"In most developing countries with limited laboratory facilities, TB patients are tested for MDR-TB only after they fail to respond to first-line drugs. Patients have to wait for the test results before they can be put on second-line drugs. During this period, they can spread the MDR disease to others. Often, the patients die before results are known, especially if they are HIV-infected in addition to having MDR-TB. The new technology is a revolutionary breakthrough which will contain such a transmission," Dr Weier said.

According to Dr Weier, this molecular test to diagnose MDR-TB, made possible through $26.1 million in funding from UNITAID, will first be introduced in 16 countries which includes Bangladesh, Indonesia, Myanmar, Vietnam and Ukraine. India will receive the technology under the second phase, by the end of 2009.

"Four African countries will start using the technology in the next three months. Between 2009-10, WHO's Global Laboratory Initiative and Foundation for Innovative New Diagnostics will help countries prepare for installation and use of the new rapid diagnostic tests, ensuring necessary technical standards for biosafety and the capacity to accurately perform DNA-based tests. Lab staff will be trained and lab facilities will be enhanced in 12 other countries to start using this test," Dr Weier said.

TB infects 8 lakh people every year in India and when treated inappropriately (the administration of drugs is stopped prematurely or is not done properly), the patient may not only remain sick, but the bacteria that causes the illness may develop resistance to drugs ordinarily used to treat TB. MDR TB is difficult to treat, as the drugs used are often toxic and can cause side effects. The people infected with this disease spread it readily to others.

Treating MDR TB patients is also expensive. Treating a normal TB patient costs India's Revised National TB Control programme Rs 600 over 6-8 months time. Treating every MDR-TB patient will cost RNTCP Rs 1.5 lakh over 24-28 months.

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