A new programme aims to use innovative technologies to improve the detection and treatment of tuberculosis (TB) in China.

Cutting edge diagnostic tests, drug regimens that reduce the number of pills a patient needs to take, and innovative ways of ensuring patients take their drugs — such as mobile phone text messaging — will all be rolled out under a programme led by the Chinese Ministry of Health.

The five-year initiative was announced this week (1 April) on the sidelines of a high-level ministerial meeting — involving more than 27 countries — on multidrug and extensively drug-resistant tuberculosis in Beijing.

It will be implemented in five designated provinces and one municipality — covering 20 million people at risk of TB.

The proposed diagnostic tools will include the use of LED microscopes and DNA-based diagnosis, Huan Shitong, a senior programme officer at the Bill & Melinda Gates Foundation, told SciDev.Net.

Using LEDs rather than standard phosphorescent lights in microscopes forms a clearer image and improves TB detection rates in patients' sputum from 50 to 65 per cent. And DNA testing, which can determine which strains of Mycobacterium tuberculosis are present in sputum has 98 per cent accuracy and can be used to detect drug-resistant strains in as little as a day.

DNA-based diagnosis is cost-effective, says Rajendra S. Shukla, joint secretary of the Indian Ministry of Health and Family Welfare. DNA tests were piloted in India at the end of 2008, and cost US$14 for the general public, he says.

As well as diagnosis, new management methods such as mobile phone text messaging and medicine kits with built-in reminder alarms will be used to enhance patients' drug compliance. Drug combinations — where different drugs are combined in the same pill — will also be used to reduce the number of pills a patient has to take from around 13 to three or four a day.

After two-and-a-half years effective interventions will be scaled up. Some 20 cities covering 100 million people should be included by the end of the fifth year of the programme, funded by a US$33 million grant from the Bill & Melinda Gates Foundation.

Margaret Chan, director general of the WHO, expressed her optimism for the programme, saying that China has a successful record of reaching TB control targets, a high level of political commitment and guaranteed input of domestic resources.

Statistics from the WHO put the number of Chinese TB patients at 1.3 million, second only to India.

Source: SciDev Net
Date: 3 April 2009