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Tuberculosis is that one disease that we Indians have not been able to eradicate successfully. It remains one of the world's deadliest infectious diseases contributing to an estimated 1.5 million deaths in 2013, according to the World Health Organisation. Many HIV patients also suffered due to TB. An estimated 95% of TB deaths globally occur in low- and middle-income countries.A study conducted in three countries including India, claims that three new tests for more rapidly diagnosing drug-resistant forms of TB could help make treatments more effective and reduce mortality.
Experts say drug-resistant forms of TB are much difficult and more expensive to treat and represent a significant threat to global public health. 'Our study shows that TB testing that once took two to three months can now be done in as little as a day,' said co-author Richard Garfein, professor at the University of California, San Diego School of Medicine. This means people can be on the right medications sooner, spared from the toxic effects of drugs that are ineffective. The test will also prevent the development of drug-resistant forms of TB that can occur with the wrong medications.For the study, sputum (a mixture of saliva and mucus coughed up from the lungs) from 1,128 study participants at TB clinics in India, Moldova and South Africa were examined. They were tested using three rapid tests for detecting drug-resistant forms of TB.Two of these tests use molecular techniques to look for genetic mutations in the pathogen's DNA that confer resistance to antibiotics. The third test employs an easy-to-use version and low-cost and of the standard bacterial culture technique, making it suitable for clinics and hospitals with limited resource.Results from the rapid tests were then compared to the standard reference method for detecting resistance to seven of the most important anti-TB drugs.
These comparisons showed that all three rapid assays accurately identified resistance to first- and second-line oral antibiotic treatments (isoniazid, rifampin, moxifloxacin and ofloxacin). They were less accurate but still superb at detecting resistance to injectable antibiotics (amikacin and capreomycin) typically administered to those with multi-drug resistant TB. The rapid tests performed poorly in detecting resistance to only one drug, the antibiotic kanamycin, which is also used to treat multi-drug resistant TB. The study also listed the time it took to obtain results. The molecular techniques performed better, with a mean time of 1.1 days for both DNA testing methods; 14.3 days for the rapid culture method; and 24.7 days for the reference standard test. A urine test can also detect tuberculosis.
The study was published in the journal PLOS ONE.
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