CityPress - - News - LUBABALO NGCUKANA lubabalo.ngcukana@city­press.co.za

Gov­ern­ment has lauded the suc­cess­ful test­ing of a tool which uses urine to find out if an HIV-pos­i­tive pa­tient also car­ries tu­ber­cu­lo­sis (TB) bac­te­ria. It yields re­sults much faster than the tra­di­tional method of send­ing spu­tum to a lab­o­ra­tory. Hence, treat­ment can be ini­ti­ated with­out delay.

The test­ing method is be­ing rolled out na­tion­ally fol­low­ing pi­lot pro­grammes con­ducted at var­i­ous hos­pi­tals, namely Um­lamli and Cofimv­aba hos­pi­tals in the East­ern Cape; and Murchi­son and Church of Scot­land hos­pi­tals in KwaZulu-Natal.

Dr Vuyo Yokwe, a gen­eral prac­ti­tioner and clin­i­cal man­ager at Um­lamli Hospi­tal in Sterk­spruit, said the na­tional and pro­vin­cial health de­part­ments ap­pointed these four hos­pi­tals to pi­lot the Lipoara­bi­no­man­nan (LAM) test. LAM is the pro­tein found in the urine of patients when TB bac­te­ria cells break down.

“The pi­lot pro­ject started in Septem­ber last year to test for TB us­ing a urine spec­i­men,” said Yokwe.

“It has never been done be­fore in South Africa, but I am not sure if this has been the case in pri­vate prac­tice.”

The re­search team was led by Dr Lindiwe Mvusi, di­rec­tor of the TB con­trol and man­age­ment clus­ter at the depart­ment of health.

Af­ter re­searchers re­ported on the suc­cess of their find­ings last month, the na­tional roll-out of this test­ing pro­ce­dure is likely to com­mence be­fore year-end.

Yokwe said tests were con­ducted only on HIV-pos­i­tive patients sus­pected of car­ry­ing the TB bac­te­ria.

The LAM test method uses a sim­i­lar in­stru­ment to the strip that is ap­plied when test­ing for preg­nancy, and both ex­am­i­na­tions in­volve urine.

“You take a urine spec­i­men and pipe it to the test strip,” said Yokwe.

“It looks ex­actly like the strips used in con­duct­ing HIV or preg­nancy tests, where you see the re­sults within 20 min­utes. But it is ad­vis­able for peo­ple to still go for a con­fir­ma­tion test.

“The ad­van­tage of this test is that it tells you within 20 min­utes whether you can start treat­ment for TB, as op­posed to get­ting re­sults a week or so later.”

Un­like the preg­nancy test kit, which can be ad­min­is­tered at home, the LAM method still has to be done at a hospi­tal or clinic. The equip­ment is slightly dif­fer­ent from that bought at a phar­macy.

The test is aimed at peo­ple who are HIV pos­i­tive and have low im­mu­nity.

Hail­ing its ben­e­fits, Yokwe said: “The LAM test is tech­no­log­i­cally sound with quick find­ings and fast ini­ti­a­tion at the first de­tec­tion of TB. You can treat it and still ad­min­is­ter treat­ment for HIV. Peo­ple can die if you don’t find TB with the HIV coin­fec­tion.”

Yokwe said Um­lamli was the only hospi­tal of­fer­ing treat­ment for multi dru­gre­sis­tant TB in the en­tire Joe Gqabi re­gion. This was where all other hos­pi­tals in the district mu­nic­i­pal­ity re­ferred TB patients to.

Sizwe Ku­pelo, a pro­vin­cial health depart­ment spokesper­son, said the LAM test ap­plied to HIV-pos­i­tive patients who were sus­cep­ti­ble to con­tract­ing TB and ex­tra­pul­monary TB (in­volv­ing or­gans other than the lungs, such as the lymph nodes, ab­domen, skin, joints and bones) and whose CD4 cell count was be­low 100.

He said the test was help­ing to fast-track di­ag­no­sis of TB and start treat­ment early on be­cause these patients would be very ill and, at times, un­able to pro­duce spu­tum for gen­eral test­ing.

How­ever, added Ku­pelo: “The test does not iden­tify multi- and ex­ten­sive dru­gre­sis­tant TB, so patients who re­quire this will be as­sisted to pro­duce spu­tum for test­ing.”


QUICK AND EASY The rev­o­lu­tion­ary LAM test, which checks for TB bac­te­ria in HIV-pos­i­tive patients, uses a sim­i­lar strip to those used in HIV and preg­nancy tests

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