Pilot project tests multi-drug resistant TB in children

Chennai, India – 30 April 2014 – A three-month pilot project to test at least 5,000 children between the ages of 0 – 14 for tuberculosis, including its multidrug-resistant (MDR) form, was launched earlier this month by India’s Revised National TB Control Programme (RNTCP), the National Institute for Research in Tuberculosis (NIRT), and other agencies. The project covers four cities in India – Hyderabad, Chennai, Kolkata and New Delhi – and is using Xpert MTB/RIF, an automated real-time DNA amplification technology that identifies the DNA of Mycobacterium tuberculosis, the bacteria which causes TB. The test can also determine if the child has developed resistance to rifampicin, one of the first-line drugs used in TB treatment. Funded by the United States Agency for International Development and implemented by RNTCP and NIRT, with technical support from FIND, the project will support one lab in each of the four cities. The specimens will be processed on the same day of receipt, and results will be sent directly via SMS to pediatricians. “Pediatricians or even parents themselves can give us specimens for testing and it is done free of cost,” said Dr C.N. Paramasivan of FIND.

At the launch of the project in Chennai, Dr Jagdish Prasad, Director General of the Ministry of Health and Family Welfare, commented that “Irregular treatment, quality of diagnosis and prescribing more drugs than required are all challenges we face. Recently I visited slums in Mumbai, and though we say that things are better, drug-resistant TB is rampant and mortality is very high. We want to find out how many kids have MDR-TB, as we have one-fifth of the world’s TB burden.” Tuberculosis is particularly difficult to diagnose in infants and children for they cannot or have great difficulty expectorating the sputum needed for analysis.

“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 Soumya Swaminathan, Director of NIRT. “Though there are no precise figures, at ICMR (India Council of Medical Research), there are 85,000 kids who are brought in with TB every year. We strongly suspect that the number of children who have TB and MDR-TB is twice as much as the current numbers suggest,” she explained.

Tuberculosis is a deadly, communicable disease which takes a heavy toll on patients and their families. Rapid diagnosis of TB, followed by the correct treatment, is critical in stopping progression in the individual and spread to others.

About FIND India
FIND India opened its doors in 2007, beginning with a memorandum of understanding with the Central TB Division, Ministry of Health and Family Welfare, to demonstrate and introduce new, rapid, and quality-assured tests for tuberculosis (TB) at affordable prices for the public health sector. FIND India’s activities initially focused on evaluation and demonstration studies of diagnostic tools that FIND had co-developed with partners, including liquid culture and drug susceptibility testing, rapid speciation, molecular line probe assay, LED-based fluorescence microscopy and Xpert MTB/RIF. The data from these studies formed part of the body of evidence that ultimately enabled their endorsement by the World Health Organization (WHO). India’s Revised National TB Control Programme (RNTCP) has also used these data to help formulate its guidelines for the detection and management of drug-resistant TB across the country. Nine years later, FIND India’s portfolio of work has expanded to include hepatitis C and antimicrobial resistance, while still maintaining a strong focus on TB.