Dear Docs, Medicos and Friends of science

Faster TB test 'could save lives' http://news.bbc.co.uk/1/hi/health/6037053.stm

A faster, more accurate tuberculosis test has been developed by scientists. The
microscopic-observation drug-susceptibility (MODS) test is also cheaper and more
sensitive to drug resistant strains than current tests. It yields results in an
average of seven days, and could help save many lives, particularly in
developing countries - where TB is rife. Details of the test, developed by UK,
US and Peruvian researchers, feature in the New England Journal of
Medicine.Existing TB tests do not always detect bacteria


The researchers hope it will lead to faster treatment for many people, reducing
the severity of their symptoms, and the chances they will infect others. It is
thought that more than two million people die each year from TB. The common
strain is almost 100% treatable, but multi-drug resistant strains are becoming
an increasing problem. At present, the World Health Organization recommends the
sputum smear microscopy test, which analyses the material expelled from the
lungs by a deep cough. However, the test, although fast, is not accurate in
around 50% of cases, and it can take up to six weeks to culture the sample,
confirm the results and determine whether it is resistant to drugs - these
detailed checks are only rarely available in the developing world. The MODS test
allows doctors to diagnose TB twice as quickly as previous gold-standard culture
tests and to identify multi-drug resistance in a third of the time. In tests on
nearly 4,000 sputum samples MODS identified TB with 97.8% accuracy -
significantly out-performing the current tests.

Faster growth

MODS works by culturing the TB organism in a liquid, rather than the traditional
solid substance. This enables it to grow more rapidly, and for scientists to
detect its characteristic pattern of tangles or coils under a microscope
relatively easily. The liquid media also means TB drugs can be more easily
administered for testing: if the bacteria grow in the presence of these drugs,
this indicates resistance. The researchers said the new test could dramatically
help those who have contracted multi-drug resistant TB (MDRTB), and had been
shown to be highly effective where cases of TB were combined with HIV infection.
Researcher Dr David Moore said: "In one study in Lima, half of HIV patients with
MDRTB were dead within two months of commencing TB treatment, the minimum time
to get results from standard tests in Peru or indeed almost anywhere in the
developing world. "Their MDRTB had gone undetected and so they had received the
wrong treatment. "A correct diagnosis at the start of treatment would have
improved many of their outcomes." Professor Peter Davies, secretary of the group
TB Alert, said: "This is a very exciting development, which offers the best hope
of a quick diagnosis for the 50% of people in the developing world who are not
detected by the current test."



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