A delay in procurement of cartridges used in Genexpert machines has left several tuberculosis patients in a lurch in the city. Sion Hospital, that receives several TB patients and HIV plus TB affected patients, stopped conducting the test over a month ago.
Genexpert is a molecular test for tuberculosis (TB) to detect if a patient has developed resistance to Rifampicin , a drug commonly used in treating TB bacteria in first line of treatment. A patient is categorised as multi-drug resistant (MDR) once Genexpert detects that the bacteria in sputum of patient is resistant to Rifampicin drug. The test takes two hours, speeding the conventional backlog that used to exist in traditional diagnostic methods. Introduction of this test has also sped initiation of treatment for MDR-TB patients.
“In May, Pune and parts of Maharashtra reported acute shortage of Genexpert MTB/ RIF test. State TB officer sent circular to Central TB division, Delhi, but still we are facing shortage in Mumbai since last month,” a complaint sent on September 7 (Thursday) by group of HIV and TB positive patients to Mumbai district TB officer, Dr Daksha Shah, said.
According to an official from Revised National Tuberculosis Control Programme (RNTCP), the center has delayed sending cartridges which has hampered molecular tests in several government diagnostic centers in Mumbai. “The new stock came recently. It will last till January next year. Then we will have to again put demand for new supply,” the official said.
Sion hospital has two machines of Genexpert, one for pulmonary that is used for lungs, and two for extra-pulmonary TB, for detecting bacteria outside the lungs.
According to Ganesh Acharya, HIV and TB positive patient, there are 150 HIV positive patients suffering from TB who consult Sion hospital for tests and treatment. In Mumbai, the count of such patients is over 1,000. “Patients have been asked to return after few days for tests or get it done privately,” he said.
Patients diagnosed with HIV have to compulsorily undergo TB test because of being at higher risk of contracting the latter. Acharya added that several patients visiting Sion hospital cannot afford private diagnosis through Genexpert. A single test may range between Rs 1,500 to 3,500.
Another RNTCP official said the issue has persisted for few days but not in all centers where genexpert machines are available. Mumbai has 22 such machines spread in government hospitals, including Kandivali Shatabdi, Govandi Shatabdi, JJ, and Sion hospital, where maximum patients visit for testing.