Imagine if patients with suspected tuberculosis, possibly drug resistant, could be diagnosed, no matter where they live, immediately and reliably at their local health centers — even if their local health centers had unreliable electricity, and no laboratory.
It would be possible with a light-weight, portable wireless device that can be attached to a smartphone. The machine Would diagnose not only tuberculosis but an array of other diseases quickly and accurately. Running on a battery it wouldn’t require electricity, and could be thrown into a backpack for health workers to take on the go. An extra battery pack could offer 12 hours of power.
Cepheid, the makers of the diagnosis-landscape-changing GenXpert, made the vision a reality with the GeneXpert Omni, Phillipe Jacon of the company, said on Wednesday after the launch of the World Health Organization annual report on tuberculosis. The report said that only about a third of an estimated nearly half million cases of multidrug-resistant tuberculosis each year are accurately diagnosed and reported to national TB programs.
“While the GeneXpert is used in 224 out of the 227 hospitals in South Africa,, the Omni can be present in all 4302 health centers,” Jacon said.
The Omni, weighing in at only 2.2 pounds, runs on a rechargeable battery and uses the same cartridge the larger GeneXpert machine uses. Because the device connects to a smartphone and is so portable, it can be used outside major hospitals and in smaller health centers to diagnose drug resistant tuberculosis, and 23 other diseases.
“We want the Omni to be known as the “backpack machine,” not just the TB machine,” he said.
The Omni will cost $2,895 while the cost of the cartridges will remain around $10, Jacon said.
The Omni will be available in countries early next year, and is intended for countries with emerging economies and high tuberculosis burdens. That includes India which accounts for 23 percent of all global tuberculosis cases.
Jacon’s presentation was preceded by a look at some of the challenges in where physicians largely rely on chest x-rays to detect tuberculosis, according to Jishnu Das, of the World Bank. And only 12 percent of patients are given chest x-rays when they first present with symptoms, Das said, citing a study conducted he and his colleagues conducted, looking at the gaps between medical knowledge and implementation of that knowledge among Indian clinicians.
Das noted that eighty percent of healthcare providers in India practice in what is widely called “the private sector,” — a sector largely made up of providers with no formal medical training. “They,” Das said, “are the first point of entry for many TB patients in medical care.”
Even when providers had medical training (more common in urban than rural settings, according to the study) Das and his colleagues, found most did not put their knowledge into practice. “There is a huge gap between what they say they will do and what they actually do,” he said.
Standards of care vary greatly across the country as well, with unlabeled medicines being sold in New Delhi and Mumbai but not in Patna, Das said,
The good news? India, with the highest burden of tuberculosis globally, including a high burden of drug-resistant forms of TB, has just ordered its first Xpert machine.