2012年8月9日星期四

Now, multi-drug resistant TB test to cost 40% less

 Funds provided by the partnership will reduce the cost of Xpert from $16.86 to $9.98, a price that will not increase until 2022.

The high cost of the tool was the main barrier to their introduction and widespread use. India just recently decided to roll out Xpert across 18 sites to test for and confirm MDR TB. The sites, where the new test has been introduced include Rohtak (Haryana), Dharavi (Mumbai), Amravati (Maharashtra), Udaipur and Jodhpur (Rajasthan), Bilaspur (Chhattisgarh), Malkangiri (Odisha), Tehri (Uttarakhand), South 24 Parganas (West Bengal) , Sangam Vihar (Delhi), Indore (Madhya Pradesh) and two sites each in Vijayanagaram (Andhra Pradesh), Kamrup (Assam) and Ranchi (Jharkhand).

Around 99,000 Indians suffering from TB are becoming drug resistant every year.

The only method used in most laboratories in India was smear microscopy, a technique developed in the 1880s by the German bacteriologist Robert Koch that requires visual detection of the TB bacterium under a microscope. Smear microscopy is insensitive for diagnosing TB in patients who are co-infected with HIV and also does not detect MDR TB.

It also took two days to almost four months to confirm a single drug-resistant case, during which time the air-borne disease spreads to others.

A large percentage of people with TB fail to start treatment promptly because of the long wait for results of older conventional tests. In India, around 3% of all new cases and 12%-17% among retreatment cases are MDR. In 2010, 2.3 million TB cases occurred of which 360,000 people died - nearly 1,000 deaths per day. Nearly one in six deaths among adults aged 15-49 in India are due to TB.

Introduction of Xpert is expected to increase TB diagnosis by at least seven-fold.

The biggest advantage of the Xpert system is that it can be used outside of conventional laboratories and does not require specialized training.

Greater access to this test will help health care workers diagnose TB quickly and help reduce TB transmission, the development of TB disease and premature TB deaths /a>. The capacity of the Xpert to yield a rapid and accurate diagnosis has the potential to improve TB diagnosis and treatment in rural clinical settings.

Research suggests that the incremental scale up of Xpert 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.

According to WHO, the four countries with the largest number of estimated cases of MDR-TB in absolute numbers in 2008 were China (100,000), India (99,000), Russia (38,000) and South Africa (13,000).

Now, only 7000 MDR TB patients in India are on treatment. But from 2015, all suspected cases will be tested for MDR TB.

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