A month after Gene Xpert, a diagnostic tool that detects multiple drug resistant tuberculosis (MDR-TB), was installed in Dharavi, 28 patients have been detected with MDR-TB from among more than 400 samples.
To mark World TB Day on March 24, the Brihanmumbai Municipal Corporation (BMC) started feasibility study of the device, which can test TB and MDR-TB in less than two hours at the Urban Health Centre in Dharavi. The other tests take a minimum of three days to confirm TB.
The Gene Expert test is called Cartridge Based Nucleic Acid Amplification Testing, which tests presence of TB bacteria and resistance to anti-TB drug rifampicin. The tool called Gene Xpert, which conducts this test, has World Health Organisation (WHO) approval and recommendation. Experts said the device could lead to three times more detection in drug-resistant TB. "In the past one month we have tested around 12 patients daily. Of the 28 MDR-TB patients seven have already been put on Category 4 treatment," said Dr Minni Khetarpal, Mumbai TB Officer. Fifty-two people tested positive for primary TB and 37 of them have been started on the directly observed TB short course (DOTS). A normal drug sensitivity test takes up to six to eight weeks and a line probe assay test takes up to 72 hours to confirm MDR-TB.
Doctors said nearly 10% of MDR patients die before treatment can start. "This device reduces the diagnosis time from eight weeks to six hours for the patient and treatment can start almost immediately. It also stops transmission in the community," said Dr Zarir Udwadia, consultant chest physician, Hinduja Hospital. "We have been able to screen more than 700 people in a month and 10 more sites are near completion," said Dr Neeraj Raizada medical officer, Foundation for Innovative New Diagnostics.