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Rapid test for drug resistant TB
An international initiative aims to speed diagnosis and care of patients with multidrug-resistant tuberculosis in developing countries.
Monday, 30 June 2008 20:16

The World Health Organization is working with partners to make a rapid test - which gives results in two days - more widely available.

Currently, standard tests take up to three months to produce a result.

There are also plans to boost the supply of drugs to treat MDR-TB in 54 countries - and cut their cost.

MDR-TB responds poorly to standard treatment because of resistance to the first-line drugs isoniazid and rifampicin.

It is estimated only 2% of MDR-TB cases worldwide are being diagnosed and treated appropriately - owing mainly to inadequate laboratory services.

The aim is to increase that proportion over the next four years to at least 15%.

The WHO is working on the new initiatives with the Stop TB Partnership, Unitaid, an international drug purchase facility, and the Foundation for Innovative New Diagnostics (Find).

In developing countries most TB patients are tested for MDR-TB only after they fail to respond to a standard treatments.

Even then, it takes two months or more to confirm the diagnosis.

Patients have to wait for the test results before they can receive life-saving second-line drugs.

During this period, they can spread the multidrug-resistant disease to others.

Often the patients die before results are known, especially if they have HIV in addition to MDR-TB.

Staff trained up

The new initiative aims to make diagnostic tests known as a "line probe assays" widely available over the next four years.

The tests are currently only used in research settings, but there are plans to enhance lab facilities and train up staff to use the tests in 16 countries with a significant MDR-TB problem.

One country, Lesotho, is already equipped to start using these tests. Ethiopia is expected to be ready by the end of 2008. The tests will be phased in from 2009-2011 in the remaining 14 countries.

This initiative will be complemented by a US$33.7m deal struck by Unitaid to boost the supply of drugs to treat MDR-TB, which it is hoped will also cut the cost of the drugs by up to 20%.

Dr Margaret Chan, WHO director general, said: "Five months ago, WHO renewed its call to make MDR-TB an urgent public health priority and today we have evidence to guide our response."

BBC

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