The Promise of Next-Generation Sequencing, Continued Progress in Kenya, Testing Goes Mobile in the Philippines
TB Tidbits News Scan, September 13, 2023
Targeted Next-Generation Sequencing Paves the Way for a New Era of TB Diagnostics
A new platform, Targeted Next-Generation Sequencing (tNGS), is revolutionizing the diagnostic experience for drug-resistant tuberculosis (DR-TB) patients. The technology, which focuses on specific regions of the genome, can be used to efficiently diagnose drug-resistant TB cases, offering patients an accelerated, comprehensive and clinically valid alternative to existing methods. Unlike Whole-Genome Sequencing methods, tNGS can be performed directly on patient sputum samples, eliminating the need for culture-based drug susceptibility testing. Further, the technology facilitates real-time identification of resistance-conferring TB mutations, enabling healthcare workers to more promptly make treatment decisions.
Despite its promise, tNGS is still a complicated tool to deploy, requiring both specialized data-processing infrastructure and advanced user training. Additionally, other factors like a highly complex installation process, supply chain instability, and unreliable internet connectivity could slow adoption and integration of the tool. Still, experts are encouraged by the platform’s potential, with the WHO issuing a rapid communication in July deeming the tech feasible for implementation in centralized settings.
Kenya Doubles Down on Commitment to Eradicate TB
This past July, Kenya’s Ministry of Health partnered with USAID and the Stop TB Partnership to distribute 78 Truenat machines and 8 digital chest x-rays across 47 counties within Kenya. Kenya’s Ministry of Health hopes the deployment of the machines, collectively valued at $3 million, will help strengthen diagnostic capabilities in high-risk areas. Though Kenya remains on WHO's high burden TB list, the African nation has made great strides in recent years in its efforts to combat the diseases. Between 2015 and 2020, Kenya reduced its TB incidence rate by 34%, a number much higher than the WHO global milestone which called for a 20% reduction by 2020.
On July 27, the Principal Secretary of Kenya’s State Department for Public Health and Professional Standards, Mary Muthoni, spoke at the 4th Africa TB Summit about some of the strategies Kenya has implemented to successfully advance the fight against TB. During her remarks, Secretary Muthoni stated that Kenya is the first country to implement child-friendly TB medicines and adopt injection-free treatment regiments for drug-resistant TB. She also noted that Kenya has scaled the use of WHO approved molecular tests for TB across all counties. Furthermore, in 2019, Kenya adopted pop-up screening booths, which are easy-to-install, ATM-like screening facilities that are set up in highly-trafficked areas. The booths provide users with a digital questionnaire to help determine whether a person should be tested for TB. From 2019 to 2021, booths in five locations conducted 85,000 screenings.
Mobile Van Donated to Philippines Department of Health Provides TB Services in High-Risk Regions
In July, the Global Fund donated a mobile TB testing van to Philippines Department of Health, to bolster active case finding efforts in the country’s Western Visayas region. Over the next few years, the van will be deployed to geographically isolated and disadvantaged areas to provide free mobile testing to TB patients.
The donation comes on the heels of an announcement in early July from the Philippines’ Health Secretary that the country would be unveiling several new strategies to accelerate the fight against TB. As part of this renewed effort, the Department will be expanding case finding interventions in high-risk settings and will be ramping up advocacy campaigns to promote public awareness of tuberculosis and reduce social stigma related to the disease. Furthermore, the Department will leverage emerging technologies – like AI-powered tools – to enhance diagnostics and screening for TB. To improve treatment adherence amongst TB patients, the Secretary also stated the recommended treatment regimen will be shortened to four months.