The Department of Biotechnology (DBT) will soon start research focusing on the early and accurate diagnosis of active, latent and multi-drug-resistant TB (MDR-TB) in India. MDR TB has been the leading single cause of mortality across the world, especially in India.
The broad areas covered under the research projects will include development of newer diagnostic techniques that focuses on specificity and sensitivity issues higher than existing tests. The study will focus on getting the result within four to six hours and on developing specimen processing rate that will lead to at least 20 tests per day. The study proposes to focus on the developing a kit design that is self-contained, portable, battery-operated with option for charging and require minimum maintenance etc.
Despite all the advances made in the treatment and management, TB still remains as one of the main public health problems, particularly in the developing countries like India. The response of patients with MDR-TB to treatment is poor and the mortality rate is usually high. Since these patients need to be treated with expensive and toxic second line drugs, and may require hospitalisation to manage their toxic reactions and other complications, they require a sizeable proportion of health care resources.
MDR-TB caused by MTB, resistant to both isoniazid and rifampicin, with or without resistance to other drugs, is among the most worrisome elements of the pandemic of antibiotic resistance. Globally, about three per cent of all newly-diagnosed patients have MDR-TB. The proportion is higher in patients who have previously received anti-TB treatment reflecting the failure of programmes designed to ensure complete cure of patients with TB. While host genetic factors may probably contribute, incomplete and inadequate treatment is the most important factor leading to the development of MDR-TB. The definitive diagnosis of MDR-TB is difficult in resource-poor low-income regions because of non-availability of reliable laboratory facilities.
With this project the DBT aims at developing new or evaluating existing diagnostic tools, imaging or therapeutics in clinical or population settings and aim at providing them at the primary care clinic level preferably under a programme like revised national tuberculosis control programme (RNTCP). The RNTCP, initiated in India in 1992, uses the directly observed treatment short-course (DOTS) strategy and now covers more than half the Indian population.
Apart from inviting proposals from the scientists for the research projects DBT has also invited proposals for two diagnostic tools real-time PCR for rapid diagnosis of tuberculosis and MDR-TB and Line Probe Assay (LPA) for rapid diagnosis of MDR-TB which are already in use in other parts of the world to be made indigenously under 'Import Substitution Package'.