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New TB test must reach more people

A new diagnostic tool that reduces to two hours the time needed to detect drug-resistant tuberculosis must be made available to populations vulnerable to the disease, a World Health Organisation expert said.

Asia carries more than half the global caseload of drug resistant TB, which is very difficult to treat.

Patients need to take medication for up to two years and the worst type of TB, for which there is no cure, kills one out of every two patients.

"New diagnostic tools offer the opportunity to increase the sensitivity of TB diagnosis in general and to shorten the diagnosis of MDR-TB (multidrug-resistant TB) from eight weeks to two hours," Catharina van Weezenbeek, regional adviser on TB for the WHO in the Western Pacific region, said on Thursday.

"These tools are very expensive, but the scale up should be carefully planned. That requires money, training, infrastructure," she said in a telephone interview after a meeting organised by the WHO in the Philippines on the disease.

The meeting was attended by representatives from countries in the Western Pacific region with a high TB burden, such as China, Cambodia, Vietnam, Laos, Philippines and Papua New Guinea.

TB caseloads increasing rapidly every year

According to the WHO, there are 120,000 new cases of MDR-TB in the Western Pacific each year, which makes up 28 percent of the global caseload.

Combined with cases in southeast Asia, all MDR-TB cases in Asia make up 58 percent of the global caseload.

Drug-resistant TB emerges when patients fail to follow treatment regimens, take substandard drugs or stop treatment too early. Patients with drug-resistant TB can then transmit the disease to others.

"We are not detecting enough TB cases and we are not detecting them early enough. We have to target high risk TB groups, such as migrants, the homeless and patients with certain risk factors, like HIV," Van Weezenbeek said.

"We are doing a poor job when it comes to diagnosing TB in children. We expect to increase the detection of childhood TB by the introduction of routine contact investigation, ensuring that the household contacts of infectious patients are screened."

China ranked second in the world with 112,000 drug-resistant TB cases in 2007, after India with 131,000. Russia has 43,000 cases, while South Africa has 16,000 and Bangladesh 15,000.

TB killed 1.8 million people across the world in 2008, or a person every 20 seconds. It is not only a scourge in poor countries but also in the West, where it has flared anew in the last 20 years because of Aids, which weakens the immune system. (Reuters Health/July 2010)

Read more:

HIV and TB: the scourge of Africa

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