According to World Health Organization, India leads the world in terms of Tuberculosis burden. Not only this, India also leads the world in the number of cases of Multi-Drug Resistant TB. (MDR-TB). The government of India had a target to make India TB-free, by the year 2025. However, the recent coronavirus pandemic has left the TB patients in the lurch, due to the lack of testing and healthcare facilities available. What’s worrying is the fact that in the last 5 months, Tuberculosis notifications have dropped by over 50%, and over 3,00,000 cases have missed the notification mark. These numbers are making doctors across India anxious about the increasing rate of community TB transmission.
As the lockdown is coming to a halt, a rapid surge in the number of TB patients is being recorded by hospitals. However, a majority of the patients are not able to get tested or receive TB treatment. This is because the government hospitals are packed with COVID-19 patients, and the private sector hospitals are not functioning at their full capacity. Moreover, TB patients are being shunned off by the society because their symptoms are similar to that of COVID-19.
Can Technology Help Detect Both TB & COVID-19 Patients?
The need of the hour is for the National TB Elimination Program to resume TB testing services, such as microscopy, rapid molecular testing and drug-susceptibility testing as soon as possible. As the symptoms of COVID-19 and TB are the same, dual testing should be initiated. Much to our relief, India has 3 existing technologies that can implement dual testing for these diseases.
One such technology is based on AI algorithm. It’s a digital chest X-Ray tool (CXR), which rules out the need of radiologists to personally read the results. If a CXR based on AI algorithm suggests TB, then a confirmatory test such as ‘GeneXpert’ can be done to confirm the diagnosis. An Indian company, named Qure.ai, has developed a diagnostic test based on this technology named ‘qXR.’ You’d be surprised to know, that this test is even more accurate than a radiologist!
qXR is being used at some sites in Mumbai, to detect COVID-19 in suspected patients by using chest X-Rays. Good news is, that it has shown some promising preliminary results and the doctors are trying to incorporate dual testing for both COVID-19 and TB using this technology.
After CXR screening is done, molecular testing is required to confirm the TB and COVID-19 diagnosis. The simultaneous testing of sputum sample can be done by using 2 technologies already being used in India.
The first molecular testing method is known as ‘GeneXpert.’ This method employs 2 types of cartridges to diagnose both the diseases. The ‘Xpert MTB/RIF’ cartridge is used to diagnose TB and the ‘SARS-COV-2’ cartridge is used to diagnose COVID-19. This method is already being used by over 1100 systems in India.
An Indian company named ‘Molbio Diagnostics’ pioneered the second molecular testing method named ‘TrueLab.’ This method uses a chip named ‘Truenat MTB’ to diagnose TB and another chip named ‘Truenat CoV-2’ to diagnose COVID-19. The ‘Truenat SARS-COV-2’ chip along with the ‘SARS-COV-2’ cartridge is approved by ICMR for emergency COVID-19 testing.
Can India Fight the Curse of TB & COVID-19?
Last week on the occasion of annual TB report release, Union Health Minister Dr. Harsh Vardhan expressed, that we all need to come together as a country, and fight the stigma surrounding TB. He further added, that to achieve the goal of TB eradication by 2025, a multi-sectoral approach is being initiated by the government.
To detect the missed TB cases, both private and government health sectors need to come together to fight a disease that’s been crippling the Indian health sector for years. India needs all hands on deck now more than ever, to face the existing health crisis. We are sanguine about the prospects of dual testing, and hope that it will help lower the patient burden on the country for both TB and COVID-19.