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  • By Lanner
  • In News
  • Posted 24/03/2011

On World TB Day (1) , Lanner has announced that the Liverpool School of Tropical Medicine will use its WITNESS simulation software to model the patient and health system outcomes in Tanzania of GeneXpert (2) , a revolutionary new technology which cuts tuberculosis (TB) diagnosis from days to hours, helping to combat the spread of the disease. 

According to the World Health Organization (WHO), 2009 saw 9.4 million new cases and 1.7 million deaths resulting from TB. It estimates that multidrug resistant TB infected approximately 440,000 people and killed 150,000.

In response to this, a five year USAID (3) - funded initiative led by The International Union Against Tuberculosis and Lung Disease (The Union), TREAT TB, was launched in 2008. As part of the programme, WITNESS will be used to model the operational roll out of GeneXpert in Tanzania in order to better understand the processes involved, and map resource requirements against patient and health system costs. The findings will be published, providing scientific data from which national policy makers and organisations like WHO can draw recommendations for the use of the technology.

Currently, the most widely used TB test, smear microscopy, is 125 years old and routinely misses half of all cases according to studies (4). A key factor influencing the spread of the disease in some countries is the rise in the number of drug-resistant strains, which are not routinely tested for unless an initial course of antibiotics fails. Typically, this process takes a number of weeks, however with GeneXpert MTB/RIF, studies have shown it not only detects the presence of TB, but also whether it is resistant to one of the most important drugs in standard TB treatment - Rifampicin. This diagnosis will have a significant impact on reducing the time for drug resistant patients to receive appropriate treatment.

Expediting diagnosis is critical in stemming the spread of all forms of TB, as according to WHO, if left undetected, a patient will typically infect 10 to 15 other people in a year. However while the potential of the technology is dramatic, it comes at a price. A 4 module GeneXpert machine is likely to cost around $17,000 for developing countries, and per test the costs are around $14 to $17 (5).

“Early diagnosis is absolutely key in stemming the spread of TB in Tanzania, and GeneXpert holds the potential to deliver rapid improvements,” comments Ivor Langley, Operational Research Analyst at The Liverpool School of Tropical Medicine. “However, given the significant levels of investment required to deliver the new technology, it is fundamental that we demonstrate the impacts on patients, the population, and health systems costs in a virtual, risk-free environment. WITNESS will help to identify the most cost efficient and effective way of implementing GeneXpert to ensure every penny spent is utilised to the end goal: reducing the spread of the disease and saving the maximum number of lives possible particularly amongst the poor where TB is most prevalent.”

(1) World TB Day

(2) GeneXpert was developed by Cepheid, a manufacturer and developer of microfluidics and microelectronics technologies for DNA analysis

(3) United States Agency for International Development

(4) The New England Journal of Medicine


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