Following the recommendation of the World Health Organization, molecular or genetic tests are set to replace the age-old sputum microscopy as the initial step for the detection of TB. The molecular tests are helpful in early detection and provide high diagnostic accuracy.
As the world adopts the new change, India too is following the recommendations of the WHO. Goa became the first state in the country to shift to 100 percent molecular testing. But its neighboring state, Maharashtra, still has a long way to go. In Mumbai, though the health experts had adopted an imported test, GeneXpert, almost 10 years ago as the first step in TB detection, a reported shortage of cartridges made the move back to sputum microscopy a few months ago. Officials now say that the shortage is over. The BMC has 42 GeneXpert machines and 200 Truenat machines, whereas Maharashtra has 147 GeneXpert and 392 Truenat machines. According to officials, they need 450 Truenat machines to completely adopt molecular testing. A senior health official has said that talks are in progress to acquire 200 more Truenat machines that will help Maharashtra reach its goal of initial molecular testing for TB detection. The Indian Oil Corporation, as a part of its CSR initiative, donated 100 Truenat machines to the state last year to ensure molecular testing at remote locations. Truenat Machine is a Made in India initiative with over 6,000 machines in action across India.
Though sputum microscopy has a role to play in the subsequent line of treatment, molecular testing has the advantage of providing results in less than 2 hours. But the biggest question for India is which machine to use for early detection. GeneXpert is imported, and its cartridges are expensive, whereas Truenat is smaller in size and more cost-effective. “Truenat is portable and doesn’t need electricity or AC. The GeneXpert machine has to be fixed and kept in a cold environment, Dr. Seema Golhait, the state TB officer, added. “GeneXpert is a more versatile machine as it gives a result within 2 hours for both drug-resistant and drug-sensitive TB variants in one go. We need to run 2 tests of 1 hour each in Truenat machines," a senior doctor quoted.
To make the national TB eradication program successful, concrete steps need to be taken and implemented by the government. Early detection and intervention are the keys to making this happen.
(Input from various media sources)
(Rehash/Dr. Sushmita Ganguli)
