World TB Day 2022: India has 27 per cent of world’s multidrug-resistant TB cases, as per Global TB report 2020.Tuberculosis (TB) is a contagious disease caused by mycobacterium tuberculosis. Though lung is the most common site of infection but almost any organ in the human body can be affected. Total burden also includes cases of latent tuberculosis wherein the person is healthy, but disease could manifest if activated.
With respect to sheer number of TB cases, India has the highest burden in the world but more importantly India also has 27 per cent of world’s multidrug- resistant cases (as per Global TB report 2020).
If we were to change the above equation, in near future, then a multipronged strategy impacting preventive, diagnostic and therapeutic fields would be required.
No method can diagnose TB with 100 per cent sensitivity
On the diagnostic side, challenges which tuberculosis throws at a treating doctor and a diagnostic laboratory are unique: firstly, the bacterium has a very slow growth rate when compared with other bacteria, 2 to 8 weeks vis-a-vis 1 to 2 days. This makes use of conventional culture method as a sole diagnostic tool a step backwards. Liquid based cultures which are the gold standard for phenotypic detection and sensitivity testing have improved the situation, but the turnaround time is still long. Genotypic methods like CBNAAT, Line probe assay (LPA) can help in quick diagnosis, but their sensitivity beyond pulmonary samples is a matter of concern and range of antibiotic sensitivity they offer is limited; so, they being used a sole method of diagnosis is also not advisable. To top it infections at some sites are better diagnosed by indirect test like Adenosine deaminase test (ADA).
In a nutshell, no method can diagnose tuberculosis with 100 per cent sensitivity and hence a multipronged approach involving biochemical, phenotypic and genotypic tests, guided by site of infection would be the ideal solution.
Addressing diagnostic challenges
Metropolis Healthcare Limited has created a TB algorithm to address the above diagnostic challenges and contribute towards TB elimination.
MHL is approved by Ministry of Health & Family Welfare through National Tuberculosis Elimination program for its TB testing, biosafety level-3 facility at Mumbai. The company offers cutting edge technology for diagnosis of tuberculosis which includes both phenotypic and genotypic tests. Tests conducted include AFB & fluorescent staining; liquid based culture (MGIT); identification of MGIT isolates through MALDI TOF; liquid culture drug susceptibility to 14 anti-tubercular antibiotics; CBNAAT; identification, speciation, and sensitivity testing of primary and second line drugs through LPA; PCR; 18 drug susceptibility through Next generation sequencing (NGS).
Since 1982, world is celebrating World TB Day on March 24th by organizing various campaigns and health awareness programs with an aim to promote diagnosis and treatment of tuberculosis in reminiscence of a hundred-year-old, landmark feat i.e., 1882 by Robert Koch’s The discovery of Mycobacterium tuberculosis, the causative agent of tuberculosis.
Investments planned
Theme of ‘World TB Day’ 2022 is to ‘Invest to End TB, Save Lives’. Metropolis Healthcare Limited in sync with this theme has planned the following investments:
- Increase the TB testing menu across our existing network by offering latest technology for detection and sensitivity testing; this will give physicians quick access to health condition of their patients. Currently over 40 MHL labs offer a TB test on their menu and 10 centres offer CBNAAT for the diagnosis of tuberculosis.
- Implement MHL TB algorithm which consists of well-defined profiles and panels that will help clinicians to select right methods for getting optimum outcome efficiently. Through this we would ensure minimal false negatives and best possible reliability of results.
