TB testing has a new friend

2017-08-06 06:01
The revolutionary LAM test, which checks for TB bacteria in HIV-positive patients, uses a similar strip to those used in HIV and pregnancy tests Picture: Emile Hendricks

The revolutionary LAM test, which checks for TB bacteria in HIV-positive patients, uses a similar strip to those used in HIV and pregnancy tests Picture: Emile Hendricks

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Government has lauded the successful testing of a tool which uses urine to find out if an HIV-positive patient also carries tuberculosis (TB) bacteria. It yields results much faster than the traditional method of sending sputum to a laboratory. Hence, treatment can be initiated without delay.

The testing method is being rolled out nationally following pilot programmes conducted at various hospitals, namely Umlamli and Cofimvaba hospitals in the Eastern Cape; and Murchison and Church of Scotland hospitals in KwaZulu-Natal.

Dr Vuyo Yokwe, a general practitioner and clinical manager at Umlamli Hospital in Sterkspruit, said the national and provincial health departments appointed these four hospitals to pilot the Lipoarabinomannan (LAM) test. LAM is the protein found in the urine of patients when TB bacteria cells break down.

“The pilot project started in September last year to test for TB using a urine specimen,” said Yokwe.

“It has never been done before in South Africa, but I am not sure if this has been the case in private practice.”

The research team was led by Dr Lindiwe Mvusi, director of the TB control and management cluster at the department of health.

After researchers reported on the success of their findings last month, the national roll-out of this testing procedure is likely to commence before year-end.

Yokwe said tests were conducted only on HIV-positive patients suspected of carrying the TB bacteria.

The LAM test method uses a similar instrument to the strip that is applied when testing for pregnancy, and both examinations involve urine.

“You take a urine specimen and pipe it to the test strip,” said Yokwe.

“It looks exactly like the strips used in conducting HIV or pregnancy tests, where you see the results within 20 minutes. But it is advisable for people to still go for a confirmation test.

“The advantage of this test is that it tells you within 20 minutes whether you can start treatment for TB, as opposed to getting results a week or so later.”

Unlike the pregnancy test kit, which can be administered at home, the LAM method still has to be done at a hospital or clinic. The equipment is slightly different from that bought at a pharmacy.

The test is aimed at people who are HIV positive and have low immunity.

Hailing its benefits, Yokwe said: “The LAM test is technologically sound with quick findings and fast initiation at the first detection of TB. You can treat it and still administer treatment for HIV. People can die if you don’t find TB with the HIV coinfection.”

Yokwe said Umlamli was the only hospital offering treatment for multi drug-resistant TB in the entire Joe Gqabi region. This was where all other hospitals in the district municipality referred TB patients to.

Sizwe Kupelo, a provincial health department spokesperson, said the LAM test applied to HIV-positive patients who were susceptible to contracting TB and extrapulmonary TB (involving organs other than the lungs, such as the lymph nodes, abdomen, skin, joints and bones) and whose CD4 cell count was below 100.

He said the test was helping to fast-track diagnosis of TB and start treatment early on because these patients would be very ill and, at times, unable to produce sputum for general testing.

However, added Kupelo: “The test does not identify multi- and extensive drug-resistant TB, so patients who require this will be assisted to produce sputum for testing.”

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