Posting from the UK on an
Australian forum commentator Alexanders gave his two pennyworth on QFT testing in developing countries
I am not sure there will be huge sales in the “poorer countries” as you call them.
Yes, the cost of testing is a big issue (do you want to eat for the next week or do you want to know if you have a TB infection?)
You also have to determine how useful a test for TB infection would be. In many poorer countries (much of India and Africa) the rates of infection are estimated to be over 50%. I cannot see any country running tests that will be positve this often as they would then have to treat all of those that are positive (only test if you are going to treat). Any such country must firstly control active disease properly. Once this has been done they can start to think about latent infection - this will take decades.
Maybe, but
WHO see things differently
By 2013 - All countries should have:
* developed a national TB infection control plan
* set up national surveillance of TB disease among health workers
* assessed major health-care facilities and congregate settings for TB infection control
*reported on the implementation of TB infection control.
Bearing all this in mind a hospital in India undertook a
study into the prevalence of TB in their HCWs
Our study showed a high prevalence of LTBI even in young nursing trainees.
So which IGRA test did they use?
We have now incorporated the QuantiFERON-TB Gold In Tube (QFT) assay in our cohort study, and after initial technical problems with quality assurance, we have successfully incorporated QFT into our annual testing protocol.
Targetting HCWs was a smart move
With the recent WHO TBIC policy guidance as the reference, Indian healthcare providers (private and public) and the Revised National TB Control Programme (RNTCP) will need to begin implementing at least a minimum package of basic TB infection control measures, and enhance capacity for TBIC at the country level with adequate budget allocation. Medical schools and teaching hospitals, in particular, have to adapt and translate the TBIC policy into concrete action.
