Moreover, two novel rapid molecular tests for the diagnosis of resistance to second-line TB drugs have also been implemented in recruiting sites – Xpert MTB/XDR and the Molbio Truenat test for resistance to secondline drugs. Results will continue to be shared with WHO and are expected to contribute to updated guidelines in 2023.
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The DIAMA project, which brings together groups in nine sub-Saharan African countries, is focusing on the diagnosis and management of patients with multidrug-resistant TB (MDRTB). Three DIAMA sites generated field data on Cepheid’s Xpert MTB/XDR cartridge, which can rapidly detect resistance to second-line drugs such as isoniazid and fluoroquinolones used in the WHO-recommended regimen for rifampicin-resistant TB. This information was considered in the latest revision of WHO guidance on TB detection.
Two of DIAMA’s African partners with advanced molecular laboratories (Benin and Rwanda) have established reference laboratories for the ‘Deeplex’ assay – a novel multiplex deep sequencing-based drug resistance diagnostic platform that provides sequence information on a range of genes that confer resistance to several key anti-TB drugs, including the new drugs recommended by WHO to treat MDRTB.
The DIAMA project contributed to the latest update of WHO guidance on TB diagnostics, and is continuing studies that will feed into future revisions.
Gathering field data on TB diagnostics