Dr Jack Richards at the launch of the GeneXpert machine in Dili, Timor-Leste
The fight against tuberculosis in Timor-Leste has taken a significant step forward with the launch of a Burnet-supported GeneXpert machine to provide rapid and accurate diagnosis.
Based at the National Reference Laboratory (NRL) in Dili, the machine is the first to be incorporated into the National TB Program.
Funded by the Royal Melbourne Hospital, the GeneXpert provides results inside two hours, compared to testing by microscopy and sputum culture, which can take up to six weeks to complete.
TB is a major public health problem in Timor-Leste with an estimated 8,000 active TB cases nationally.
Burnet infectious diseases physician, Dr Jack Richards, who attended the launch and will play an ongoing management role, said the GeneXpert is very accurate.
“Even if there’s very low numbers of the TB organism, this machine is so sensitive it will find those organisms and it will tell you whether they’re resistant to one of the key TB drugs, rifampicin,” Dr Richards said.
“It’s a lot more effective than looking under the microscope and especially beneficial with people we suspect may have multi drug-resistant TB.
“The other important thing, which we’re doing as part of a study, is that a lot of people thought to have TB, you can’t find the TB organism on their sputum.
“A lot of those people get started on TB treatment anyway because of the clinical suspicion that they’ve got TB – it’s called ‘smear negative’ TB.
“They might have lung cancer which can look very similar to TB, or a form of chest infection, but the GeneXpert can help determine whether they have TB or not.”
Image: Microbiologist Ismael Barreto poses with the NRL’s new GeneXpert machine
Dr Richards said it would be a priority to co-ordinate with the operators of two GeneXpert machines already operating in Timor-Leste outside the National Program.
It’s expected the NRL machine will be responsible for testing in a catchment comprising the entire eastern half of Timor-Leste.
“The next big challenge for us is logistical,” Dr Richards said.
“We need to ensure that samples can get from the most remote regions of the country to our machine and that we can provide a timely diagnostic test result.
“This is part of our role, supporting the machine itself by partnering with people who can provide safe and reliable transport, for example.
“There’s also support required in the hospital where many of the doctors don’t understand the technology and what it offers.
“There’s going to be a lot of re-education with them about TB and making a proper diagnosis.
“We’ll be working with the National TB Program to ensure this happens.”