Funding gaps frustrate TB testing for those with HIV
Residents from Soweto village in the outskirts of Lodwar town, Kenya being assisted by a community health volunteer to queue during a Tuberculosis screening exercise on March 23, 2023. PHOTO | POOL
Lack of funding for a rapid test for diagnosing TB in individuals living with HIV is hampering its use in countries with a high burden of TB and HIV, despite the test being recommended by the World Health Organisation (WHO), according to a study published by the European Respiratory Journal, last week.
Tuberculosis is a leading cause of death among individuals living with HIV. In 2016, 40 per cent of HIV deaths were due to TB.
However, standard diagnostic methods that involve examining sputum often fail to detect TB infections in this population. The LF-LAM (urine-based detection of mycobacterial cell wall lipoglycan lipoarabinomannan) rapid diagnostic test was developed to detect a specific protein from the M. tuberculosis bacterium in urine, thereby enabling easier and faster diagnosis and treatment.
In 2021, the WHO issued guidelines recommending the use of the LF-LAM test for individuals with HIV and TB symptoms, as well as for those with advanced HIV, irrespective of symptoms.
But according to Alberto García-Basteiro, a researcher at ISGlobal, despite its potential to reduce TB mortality, use of the LF-LAM test has proven a challenge.
A survey revealed that only three out of 22 countries in Africa did not have a national policy regarding the use of LF-LAM tests. In the remaining 19 countries, the main obstacles to national implementation was insufficient funding for test procurement and staff training, as well as inadequate adherence to guidelines in healthcare facilities.
Curiously, the LF-LAM test has been shown to be more cost-effective than other diagnostic tests. Additional barriers include issues related to the test’s supply chain.
García-Basteiro said from the study it is evident that countries with a high burden of TB and HIV require greater support to align the use of these tests with national regulations and WHO guidelines.
