IFAKARA Health Institute (IHI) has contributed in the formulation of the latest World Health Organisation (WHO) guidelines on Tuberculosis (TB) diagnostics, following its systematic review findings on the impact of new technology - Xpert MTB/RIF on patients.
Xpert MTB/RIF is a new tool for detecting Mycobacterium Tuberculosis (MTB) and resistance to rifampin (RIF), a cornerstone drug among four drugs currently in use.
According to IHI, before the new guidelines, Xpert MTB/RIF was used as an initial diagnostic test in adults who are suspected for TB but also have either HIV or Multi drug resistant TB (MDR) and children.
But, the new guidelines recommend the use of new technology as an initial diagnostic tool for adults with signs and symptoms of TB regardless of HIV or MDR status.
IHI Research Scientist Dr Frederick Haraka told journalists in Dar es Salaam that his institute had featured in the new WHO guidelines after its work on the novel technology, and contributed to new consolidated guidelines on TB that was published recently.
“Before our review, Xpert MTB/RIF was strongly recommended as an initial diagnostic test in adults who are suspected for TB but also have either HIV or Multi drug resistant TB (MDR). Now it is strongly recommended for all adults with signs and symptoms of TB regardless of HIV or MDR status”, Dr Haraka noted.
Dr Haraka is among 12 scientists forming the WHO team which reviewed a range of new diagnostic technologies endorsed by the organisation in the past ten years.
He said their review had shown that patients who were diagnosed using Xpert MTB/ RIF had better chances of surviving and being cured compared to those diagnosed using the standard of care, smear microscopy.
Dr Haraka explained that, Xpert MTB/RIF had improved patient important outcomes such as mortality, cure, treatment for TB and pre-treatment loss to follow up compared to the current sputum smear microscopy test for TB.
“This means using Xpert MTB/RIF gives more benefits to patients and TB programmes compared to smear microscopy... the new recommendation means better access for TB diagnosis for all,” Dr Haraka explained further.
He also said that Xpert was a molecular based and a patient can get the results within two hours and immediately start treatment.
It can also detect rifampicin resistance and is suitable for use at point of care use such as primary health care facilities.
Dr Haraka stated that Tanzania was among the hardest hit countries, with estimated over 100,000 cases every year with the death rate of 40 per 100,000 people.
He noted that globally, 10 million people are estimated to fall sick of TB every year with 1.5 of them dying from the disease.
The World Health Organisation has set out goals under the End TB Strategy aimed at reducing death arising from the disease by 95 per cent and cut new cases by 90 per cent between 2015 and 2035.
Commenting on his involvement and participation in the review of the testing technology along with top scientists from around the world, Dr Haraka said it was a great opportunity.
“It was a great learning opportunity on how the WHO guideline development process occurs. We are happy to have been part of this great global effort and to learn that our ten years of TB research at our Institute gets global recognition in some way” he added.