Mandy Slutsker — July 20, 2011 – 2:43 pm
Diagnosing a child with TB is difficult - so difficult, in fact, that the vast majority of childhood TB cases go unreported. Most young children aren’t able to cough up the sputum (phlegm) needed to diagnose the disease, and the most widely used TB test only detects 10 to15 percent of childhood cases. But this may not be the case for much longer.
This week, researchers in South Africa announced the results of a study that showed the newly endorsed TB diagnostic, Xpert MTB/RIF, is effective in children. This new test is able to detect twice as many children with TB as the widely-used microscopy method and in only a fraction of the time (less than two hours!) While the test still relies on a child’s ability to cough up sputum, health workers in the study gave the children saline that made it easier to produce it.
Although Xpert has not yet been approved for use in children, this study shows we are getting closer to the goal of a fast, reliable TB test for children. Xpert was endorsed by the World Health Organization for use in adults last December and represents the very latest in TB diagnostics. Instead of using a microscope, this revolutionary tool uses DNA technology to rapidly identify TB bacteria in less than two hours without the need for a high-tech laboratory. It can detect TB even in people living with HIV - something previous diagnostics have failed to do well -and can tell if a patient suffers from a drug-resistant strain of the disease.
For years, TB went undiagnosed in vulnerable groups such as women, children, and people living with HIV. Now we have the opportunity to fight TB and ensure all children have access to TB diagnostics and treatment -but we need to make the investment. As a new technology, Xpert is highly cost-effective but still fairly expensive to introduce. The support of PEPFAR, the Global Fund, and international bodies like the World Bank will therefore be vital to developing countries that need Xpert in order to turn the tide against TB and HIV.