90-minute TB test not a game changer for India

By IANS,

New Delhi : A new diagnostic technique that detects tuberculosis in 90 minutes instead of three months using the conventional method may not be effective in India as the heat and humidity would affect the equipment, experts said.

TB kills two people every three minutes in India, accounting for over three million (30 lakh) deaths a year.

The diagnostic technique, Gene Xpert MTB/RIF, was launched in the US in 2007 and is supported by the World Health Organisation. It was launched in India last year.

However, a health ministry official said the technique may not be a game changer in India due to the staggering burden of tuberculosis the country is currently facing.

The technique enables rapid diagnosis of tuberculosis, multi-drug resistant TB (MDR-TB) and TB in HIV-infected individuals in a span of 90 minutes compared to the conventional test.

"The technique cannot be used for routine testing. We have pilot projects at 18 sites going on to test its feasibility in the Indian situation where the climate and temperature conditions are different from the western countries," said Ashok Kumar, deputy director general of the central TB control division under the ministry of health and family welfare, at a conference by Stop TB partnership.

When the technique was launched September 2010, health experts pinned their hopes on the test promising a quicker diagnosis of Multi-Drug Resistant TB by looking for bacterial DNA in a person's sputum.

"The pilot projects are in consultation with the WHO. The idea is to take the test near to the districts and remote areas where the conditions under which TB originates could be different," Kumar explained.

According to experts, high humidity and high temperature may affect the equipment and cartridges used in the test. Invariable temperature can also lead to inconsistency in the results.

"Solid culture/sputum testing remains the golden standard for Indian conditions. Xpert test can be used for HIV positive patients, but not in routine testing," Kumar said.

According to officials from the TB control division in the health ministry, the cost would be incurred by the ministry. The test costs around Rs.900 ($20) per sputum sample.

Blessi Kumar, a TB prevention activist and vice chairperson of Stop TB partnership coordinating board, said thought should be given to the technique to make it effective.

"The Indian research community and pharma industry should take on the task of going deeper into the 90-minute test. It can be a scientific advancement or a stepping stone that India needs to reduce TB cases," Kumar said.