28 Jul 2013

Lack of accurate and rapid point of care test has hampered the defeat of tuberculosis (TB) in the past. This was said by Ambassador Michelle Gavin of the United States at the African regional training workshop on Xpert MTB/RIF in Gaborone.

Ms Gavin stressed that TB must be detected reliably and quickly, adding that fortunately in 2010, the World Health Organisation (WHO) recommended the use of a new diagnostic test for TB known as Xpert MTB/ RIF.

She said the test was automated molecular that could rapidly detect TB and the presence of genes that indicate resistance to Rifampicin which was an indicator of the likely presence of multi drug resistant TB.

She noted that if health care workers had greater access to this test, they could potentially diagnose and treat TB more quickly, especially in high risk populations which could reduced TB transmissions and premature deaths.  “That is why the US government has taken a deliberate step to support expansion and access to new technologies such as the Xpert that improve early diagnosis and treatment of TB,” she noted.

The ambassador said the US Government had partnered with the Ministry of Health to roll out the first 13 Xpert instruments and had successfully screened people who were living with HIV for TB and multi-drug resistant TB (MDR-TB) using the new technology since November 2012.

Ms Gavin pointed out that the technology was self-contained and could be used in rural clinic settings, potentially decreasing the waiting times for patients to be started on treatment and consequently reducing patient costs, suffering and deaths.

She indicated that the number of reported TB cases was on the decline in Botswana, while cases in Sub Saharan Africa are reported to have also decreased recently. “Maintaining and improving this trend downward is a shared responsibility and it is going to be a shared accomplishment,” she highlighted.

Meanwhile, Deputy Permanent Secretary in the Ministry of Health, Ms Shehnaaz El Halabi said in 2011 there were an estimated 8.7 million new cases of TB globally with only 66 per cent of these notified through national surveillance systems.

She said complicating the global response has been the emerging threat of drug resistant forms of TB adding that in 2011, close to half a million people contracted multi-drug resistant TB globally with only less than a fifth accessing appropriate care.

Ms El Halabi said the scourge continues to have a firm grip on Africa, a region unlikely to reach her MDG target of mortality reduction by 2015. “Within the African context, the SADC has consistently borne the brunt mainly fuelled by HIV, five of the 22 high TB burdened countries hail from this region,” she noted.

Ms El- Halabi further stated that in 2012, 63 per cent of TB patients were co-infected with HIV, adding that the nation’s resolve to fight back has remained resolute.

She said the estimated incidence, although still amongst the highest, rapidly declined by more than 50 per cent from as high as 918 per 100 000 in 2000 to the current 455 per 100 000 population in 2011.

Ms El-Halabi stated that currently 16 Xpert machines were in use across the country and highlighting that they envisage deploying an additional 18 machines before the end of 2013.

She noted that with the current roll out, they were slowly making inroads in strengthening intensified case finding for TB that has remained a challenge in most of the HIV care settings. The workshop was attended by clinical and laboratory experts from eleven countries. ENDS