Washington — Testing for tuberculosis is going to be faster, more accurate and more thorough in developing countries as a result of an announcement August 6 from the U.S. Agency for International Development (USAID), the President's Emergency Plan for AIDS Relief (PEPFAR), the Bill & Melinda Gates Foundation and other partners.
This coalition of partners has reached an agreement that will slice the price of a new and highly accurate TB test called Xpert MTB/RIF, contained in a cartridge produced by the medical device manufacturer Cepheid. The World Health Organization (WHO) has recommended use of the product, but the single cartridge price of just under $17 has been beyond the reach of many of the developing nations experiencing a high level of tuberculosis.
Technology first developed in the 1880s known as smear microscopy is still in use in many places. With a slide under a microscope, a medical technician can visually spot TB bacterium, but the method has limitations if a patient is co-infected with HIV, as many patients are in the developing world. Smear microscopy also doesn't help clinicians detect the presence of drug-resistant strains of TB, also a growing threat in the developing world.
A significant time lag between test and diagnosis is another shortcoming of the old method, because samples must be transported from the field to a laboratory. Cepheid's Xpert product can detect drug-resistant strains and the presence of HIV from a sample in less than two hours.
A press release from USAID suggests that the improvements offered by the new product may offer significant progress in the overall battle against TB. Delivery of test results more rapidly allows the patient to begin drug treatment sooner and avoid multiple trips to a clinic that could be a long, difficult journey from a rural village.
Research indicates that a broad introduction of this technology could allow for rapid diagnosis of 700,000 cases of TB disease and save health systems in low- and middle-income countries more than $18 million in health costs.
The final partner to commit to the TB-testing cost reduction scheme is UNITAID, a global health initiative backed by Brazil, Chile, France, Norway and the United Kingdom.
TB is the leading cause of death among people living with HIV in Africa. In 2010, 8.8 million people fell ill with TB worldwide and 1.4 million died from the infectious disease.
More than 95 percent of TB deaths occur in low- and middle-income countries, according to WHO, and it is among the top three causes of death for women aged 15 to 44.
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At nearly US$10 for each test, plus capital costs for the machine, it is still expensive. It also only tests for Rifampycin and not for other resistance. There is a lot of "hype" surrounding this test, and although this test is a useful one it is still not a true point of care test such as the one available for HIV testing. See www.tbfacts.org/xpert-tb-test.html for more on the Xpert TB test.