Molbio’s Truenat system is aiding TB diagnosis in Nigeria

A recent study published in Public Health Action (Vol 14 No 3) showed the impact of the WHO-endorsed Truenat system on TB and Drug-Resistant TB (DR-TB) diagnosis in Nigeria, with implications for the global fight against TB. Truenat is developed and manufactured by India-based Molbio Diagnostics to aid in the diagnosis of TB and DR-TB in remote settings at the periphery, and reduces turnaround time for TB and DR-TB diagnosis, increasing the overall case detection rate, and fast-tracked treatment initiation, thereby cutting down the chain of transmission in the community. 

Background: 

Nigeria is a country with a high burden of TB and is among the ten countries that collectively account for 75 per cent of the global missing TB cases and 70 per cent of missing DR-TB cases. One key reason for the country’s low case detection rate has been limited access to rapid molecular testing facilities at the last mile periphery. To address this gap, Stop TB Partnership, in collaboration with USAID, installed 38 Truenat devices in Nigeria under its introducing New Tools Project (iNTP) that aimed to roll out a package of the latest innovations in diagnostics, treatments and digital health technologies to strengthen TB care in high burden countries. 

The independent study analysed retrospective data from nine months prior and nine months during Truenat implementation in 34 of the country’s 38 facilities. 

Key findings of the study: 

1. Decreased turnaround time: The Truenat assays, which provide results within 60 minutes, have cut the turnaround time for TB diagnosis to under 24 hours for 57.9 per cent of cases, 20.9 per cent in 24 hours, 7.9 per cent within 48 hours, and 5.2 per cent within 72 hours, thereby enabling treatment providers to initiate treatment on time and reduce transmission.
2. Faster treatment initiation: The study demonstrated a median time to treatment initiation of just 1.5 days, way faster than prior periods. Nearly 57 per cent of patients commenced treatment within 24 hours, and another 26.1 per cent within 72 hours of diagnosis. 
3. Increased TB detection rates: The deployment of Truenat led to an increase in the TB case detection rate, with the proportion of TB-positive cases rising from 1633 (8 per cent of 20,424 tested) to 3338 (9 per cent of 37,087 tested), an additional 1704 cases in the nine months following the system’s implementation. This highlights Truenat’s effectiveness in identifying previously missed cases. 
4. Boost in DR-TB detection: Notably, the detection of rifampicin-resistant TB (DR-TB) cases increased by 4.5 times post-implementation (from 7 to 32), indicating a significant advancement in addressing drug-resistant strains of TB, which are critical to managing and addressing the global TB crisis. 

Nigeria is continuing to build its peripheral molecular diagnostic network and is installing more Truenat devices nationwide.