India: Pilot project initiated to detect TB in children

The Times of India
April 18, 2014, 9:44 p.m.

CHENNAI: For most tubercolosis patients and their families, their health is often put to test by their countless visits to hospitals and scan centres. In the end, many may be diagnosed early as having the dreaded bacteria, but several others with the infection — most of them children.

Now, in an effort to assess the prevalence of TB, especially the multi-drug resistant type, in children, the Revised National TB control programme (RNTCP) along with other agencies has initiated a pilot project in Hyderabad, Chennai, Kolkata and New Delhi to detect the bacteria at the molecular level using Xpert MTB/RIF, a WHO-recommended technology.

As part of the project, four centralised laboratories will be set up in there cities. The one in Chennai has been set up at National Institute for Research in Tuberculosis (NIRT), Chetpet.

The test, Xpert MTB/RIF, is a cartridge-based, automated diagnostic test that can identify the DNA of Mycobacterium tuberculosis, which causes the infection, and resistance to first-line drug rifampicin. Traditionally, TB is diagnosed by looking for evidence of the bacteria either through the use of the chest X-ray, sputum smear microscopy, or through the culturing of bacteria. "The final diagnosis will take at least two weeks. With this technology, we can diagnose the patient in two hours," said Dr Jagdish Prasad, director general of health services, ministry of health and family welfare. He was in the city on Thursday to inaugurate the lab at NIRT.

The pilot project, funded by United States Agency for International Development (USAID) and implemented by RNTCP and NIRT, is intended for children between 0 and 14 years.

"The project is not just aimed at detecting cases of paediatric TB, but also to assess the prevalence of multi-drug resistance TB among children," said Dr Soumya Swaminathan, director of NIRT. The labs will be manned by geneticists.

Experts say that unlike in adults, it is hard to detect TB in children, particularly in those below 8 years, as they don't spit out sputum. "The diagnosis is also complicated because the bacteria can mimic many other common childhood diseases, including pneumonia, general bacterial and viral infections and respiratory infections. So accuracy is vital," said Dr Swaminathan.

The pilot project will be undertaken for three months. Experts have invited paediatricians in private and government hospitals to give sputum samples of children for the project.

Source: The Times of India