New TB test takes 30 min and costs R40

accreditation
A urine test makes it easier to spot  TB bacteria. (iStock)
A urine test makes it easier to spot TB bacteria. (iStock)

 A quicker, simpler test for tuberculosis (TB) in people living with HIV is not being used widely enough in South Africa, despite new evidence of its benefits, according to international humanitarian organisation Doctors Without Borders (MSF).

The TB LAM test can quickly diagnose the disease in HIV patients – providing a result in as fast as 33 minutes, compared to conventional tests which can take up to two days. This was revealed at the 9th International Aids Society (IAS) Conference on HIV Science in Paris.

Advantages over sputum tests

It is effective for patients with CD4 counts (the measure of a person’s immunity) of 200 and below, and uses urine instead of sputum to detect TB bacteria. It is only effective in this group because people who are very sick excrete a high amount of bacteria in their urine – enough for the test to detect.

At only $3 (±R39) per test it is also an affordable option and does not require a laboratory or special expertise and can be performed by nurses and even trained lay people.

“The TB LAM test has advantages over sputum tests for patients with late stage HIV who don’t present with the usual signs of TB and usually find it difficult to produce sputum,” MSF’s Dr Amir Shroufi told Health-e News.

“There have been concerns over its accuracy but for patients with severe immunosuppression (very weak immune systems), our experience plus a rapidly evolving evidence base shows that this is a useful test that can help clinicians make quick decisions to start advanced HIV patients on treatment, when any delays have serious consequences.”

But he said South Africa has been slow to act on this evidence and scale-up its use.

Most deaths in people living with HIV in South Africa are caused by TB.

Good for very vulnerable patients

Shroufi said researchers in Stokholm are working on a more sensitive version of the test so it can be used for all patients – regardless of their health status. 

Deputy Director General at the Department of Health (DoH) Dr Yogan Pillay said that the reason for the delay in scale-up is that the DoH had to develop an algorithm for its use and pilot it before it could advise provinces on how to implement it.

“We had a consultation about the algorithm about two weeks ago and we have adopted it for use across the country. So LAM is in, and it's currently being scaled up. We just need to get the traction of the hospital CEOs and the clinicians to start using it,” he said.

Sekai Chenai Mathabire-Rucker, a Zimbabwean researcher who won an award for her research on the TB LAM test in Paris this week, said that the test has significant advantages for very vulnerable patients.

“Patients who come in with low CD4 counts are often so sick they can’t walk, some are even unconscious. These patients often cannot provide sputum and need treatment as quickly as possible. Unlike with sputum tests, the TB LAM test can provide results in under an hour and patients can be started on treatment the very same day. This quick time-to-treatment saves lives,” she said. – Health-e News.

We live in a world where facts and fiction get blurred
In times of uncertainty you need journalism you can trust. For 14 free days, you can have access to a world of in-depth analyses, investigative journalism, top opinions and a range of features. Journalism strengthens democracy. Invest in the future today. Thereafter you will be billed R75 per month. You can cancel anytime and if you cancel within 14 days you won't be billed. 
Subscribe to News24
Voting Booth
The ANC's leadership race is heating up. Who do you think will be elected party president at Nasrec in December?
Please select an option Oops! Something went wrong, please try again later.
Results
Nkosazana Dlamini-Zuma has got it in the bag
7% - 720 votes
I foresee a second term for Cyril Ramaphosa
83% - 8477 votes
Don’t discount a Zweli Mkhize win
10% - 1012 votes
Vote
Rand - Dollar
17.77
-0.8%
Rand - Pound
20.13
+0.5%
Rand - Euro
17.57
+0.2%
Rand - Aus dollar
11.55
-0.7%
Rand - Yen
0.12
-0.4%
Gold
1,715.78
-0.6%
Silver
20.66
-1.9%
Palladium
2,260.50
-2.7%
Platinum
921.00
-1.3%
Brent Crude
91.80
+3.2%
Top 40
59,202
-1.1%
All Share
65,613
-1.1%
Resource 10
63,687
-1.4%
Industrial 25
79,239
-1.1%
Financial 15
13,961
-0.7%
All JSE data delayed by at least 15 minutes Iress logo
Editorial feedback and complaints

Contact the public editor with feedback for our journalists, complaints, queries or suggestions about articles on News24.

LEARN MORE