TB and MDR-TB diagnosis goes the 'Make in India' way
Maharashtra has planned to roll out the scheme from November end
India, with its high tuberculosis (TB) and multi-drug resistant tuberculosis (MDR-TB) burden, has long been looking for an affordable, high-sensitivity test to be used in the most peripheral health facilities with least technical complexity, minimal infrastructure and training. To address the issue, the state health department has now come up with a cost-effective measure of using 'Make in India' initiative to identify TB cases.
The detection of MDR-TB in the state a couple of months back
took a backseat following an acute shortage of testing kits
because of less number of cartridges. The health department has
now started using a commercial nucleic acid amplification tests
(NAAT) for TB detection. Rifampicin-resistance line probe assay
(LPA) and Xpert MTB/RIF (Xpert) have also been introduced and
being scaled up within the Revised National Tuberculosis Control
Programme (RNTCP). With the success of these technologies,
promising indigenous LPAs have been developed for rapid TB
diagnostics.
TrueNat MTB is an indigenous molecular test developed by MoIBio
Diagnostics Pvt Ltd Goa for rapid detection of MTB using
real-time micro PCR (polymerase chain reaction). Automated,
battery-operated devices are used for extraction of DNA
(Trueprep Auto device) amplification (TrueNat MTB chip) and
reading the presence of specific genomic sequences (TruelabUnoDx
real-time PCR analyser) using patients’ sputum samples.
Any resistance to rifampicin (RR) is detected by doing a second
RTPCR (Reverse transcription polymerase chain reaction) as a
reflex test using the same DNA that identifies selected
rifampicin- resistance associated mutations.
“Following earlier evaluations in India, the current
multi-centric field study is being planned to demonstrate the
performance of TrueNat MTB Rif. There are five sites in
Maharashtra where 10 TrueNat machines have been installed in
each district at two microscopic centres at Mumbai, Thane,
Kolhapur corporation, Aurangabad and Hingoli,” said Dr
Sanjeev Kamble, joint director of health (tuberculosis and
leprosy).
“We have also evaluated the reports and working of the
TrueNat machines in comparison to the present CB-NAAT (more
popular as GeneXpert) machines and the reports of the diagnosis
are found to be same. The TrueNat machines costs less (Rs 4.5
lakh) to the department as it is Indian. The cost for the
diagnosis of a single person will be around Rs 300-400 whereas
the cost of cartridges of CB-NAAT machines is between Rs 2,500
and Rs 3,000. One cartridge is used to test six people,”
Dr Kamble added.
Tata Institute of Social Sciences (TISS), Mumbai, has also come
forward to provide special counsellors to counsel for the TB
programme. “TISS has given us 57 experts for the
counselling of TB patients for the state programme. The
counsellors will be assigned to work across the state and will
be there to counsel the patients at district level. Counselling
is an important programme as most of the patients stop taking
medicines before completing the course of medicines which cause
recurrence,” Dr Kamble further added.
Dr Sandeep Bharaswadkar, consultant state TB programme, World
Health Organisation, said, “Currently, there are 72
CB-NAAT (more popular as GeneXpert) in the state and more than
40 CB-NAAT machines will be added to the programme. The
evaluation and results of both the machines are same and we will
soon decide about the new TrueNat machine procurement. These
machines will be installed in all rural health hospitals across
the state.”
Source:
Pune Mirror
