Tuesday, December 28, 2010


The Gene X-pert was apparently developed by the department of defense after the events of September 11th when biological threats became a national priority in America.It was used to analyse the DNA in potential toxins in pieces of mails.In 2008,funding from Bill and Mellinda Gates Foundation ,FIND and NIH began to assess the machine's effectiveness in diagnosing tuberculosis.
Gene X-pert as per a study published in the 'Journal' identified 98 percent of active infections because the tests look for the bacterium itself,latent infections are ruled out.
Detection of latent infections would have no significance in the indian scenario because tuberculosis is so rampant in india.
Treating latent infections could be potentially dangerous and could promote drug resistance because only twenty percent of the population harbouring the infection could manifest the disease.
Inroduction of GeneXpert technology in the national health programme would pose two-fold challenges in india.
Firstly,the cost of the investment for the infrastructure which is currently being quoted as twenty five thousand dollars with each test coming up to twenty dollars each is huge for a point of care test(compare it with the sputum microscopy)
Secondly the cost of supporting and treating all the new case-loads the tests might bring to light which the experts are calculating might be threefold would be enormous.
The multi-drug resistant tuberculosis results which would be kicked up as early as one and half hours would be another challenge,bringing with it an increased burden on the health infrastructure.
Since tuberculosis is the disease of the poor,where would the money to support such a programme come from?
Would individuals and the media care enough to make the right kind of noises to put a sustained pressure on the government and advocate for the private sectors to support such a venture?
Can we dare to dream about a TB free India in the near future?
(The facts have been picked up from an article in the New Yorker-'Deadly Misdiagnosis'

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