Brazil is unable to purchase tests for latent tuberculosis for over a year

Publicação: 3 de June de 2015

The company ceased the production in June 2014 Expert says the Country has enough technology to produce the tests and even export it

Dr. Croda represented the BSTM in a workshop by Rede TB, which works along with the WHO to build a national research agenda to serve as model to the rest of the world

Dr. Croda represented the BSTM in a workshop by Rede TB, which works along with the WHO to build a national research agenda to serve as model to the rest of the world

Currently Brazil is the 17th place among those with most cases of the disease. With disease records (33.4 per 100 thousand inhabitants) and death records (2.3 per 100 thousand inhabitants) considered high, the Country faces the challenge to decrease until 2035 the disease’s incidence ratio by up to 90%, and deaths by 95%. To reach these goals, especially the current prevention methods need enhancements. One of the tests that could assist in this task, however, is not purchased by the government for over a year and until now there are no alternatives to acquire.

The tuberculin test, also named PPD (from Purified Protein Derivative), used to diagnose latent tuberculosis, the asymptomatic form of the disease. When the tests is positive for the asymptomatic form, the patient engages in a preventive treatment for tuberculosis, with a single drug. When the disease is active, it is treated with a cocktail of medications.

Among special populations such as indigenous, children and especially people living with HIV/AIDS, a preventive treatment is necesseray in order to avoid the development of the active form of tuberculosis. The PPD is able to perform the diagnosis of latent tuberculosis and recommend treatment for these populations.

The Brazilian government was ordering the kits for the 2014/15 period in last year’s first semester when the producing laboratory, from Denmark, informed it had been sold and interrupted the production.

“We are close to the middle of 2015 and there are no prospects to solve this issue. I find important to try a resolution so we can have any kind of latent tuberculosis diagnostic test”, said Dr. Julio Croda, doctor in Pathology.

According to the official note no. 25 from the Health Ministry, from last June, the negotiations to purchase the tests begun in September 2013. However, after the price negotiations, only in the middle of the last year the completion of the acquisition process, but the negotiation was not concluded.

In November 2014, the Board released a note informing the PPD test is “a complementary exam for the main laboratorial diagnostic methods of the disease, which are skin smear, clinical and x-ray exams. Still according to the Board, Brazil already offers a rapid test for tuberculosis, being one of the first countries in the world to implement this diagnostic method. Also highlighted the PPD scarcity is worldwide.

According to Dr. Croda, it is fundamental to have specific tests as PPD for the preventive discovery of latent tuberculosis. He says there are alternatives as the Igra, already in use in the USA. However, this exam is more expensive.

“Brazil has institutes, as Fiocruz, who have enough technology and conditions to produce this product nationally, capable to supply the internal demands, and even the external. The Country could assume a role to supply this deficiency: produce the PPD and make it available for the rest of the world”, said Dr. Croda.

Workshop

In April, Dr. Julio Croda was the representative of the Brazilian Society of Tropical Medicine (BSTM) in a workshop by the Brazilian Network of Tuberculosis Research – Rede TB, which works along with the WHO to build a national research agenda to serve as model to the rest of the world. “During the meeting, specific groups were created to begin developing a work proposition. It was a preliminary meeting to build a common agenda in tuberculosis research in order to serve as an example to the world of how research and innovation can impact reducing tuberculosis mortality and incidence”, said the infectious disease expert. The group started in 2001 with around 300 researchers from 60 Brazilian institutions.…