WORLD – Metropolis healthcare, an Indian multinational chain of diagnostic companies, has launched a next generation sequencing (NGS) platform that can rapidly identify drug resistance in TB patients and provide data on genotypic type level of up to 18 TB antibiotics.

The launch will be the first of its kind in India for a diagnostic service provider and will have Metropolis work alongside HaystackAnalytics, a startup providing genomics-based diagnostic services for infectious diseases.

Metropolis healthcare is targeting to launch its NGS technology in Sri Lanka, Mauritius, the UAE, Kenya, Zambia, Ghana, Tanzania as well as three other African countries to help their fight against tuberculosis.

According to India TB Report 2021, the NGS test has already been recommended by the Central TB division as a preferred diagnostic technology for TB.

However, the launch of the technology in India was to date hindered due to the lack of technical and computational bottlenecks which Metropolis Healthcare has stepped up to solve.

The launch comes timely at a period when the World Health Organization (WHO) had just issued new recommendation and guidelines for the detection of TB and drug-resistance TB.

These guidelines will be accompanied by an operational handbook to facilitate rapid implementation and roll out of rapid molecular tests by national TB programmes, ministries of health and technical partners.

According to the recommendation, three new nucleic acid amplification test (NAAT) classes are endorsed by WHO and they include:

(1) moderate complexity automated NAATs, recommended for the initial detection of TB and resistance to rifampicin and isoniazid, providing more options for early diagnosis of TB and rifampicin-resistant TB but also addressing an important gap in the rapid diagnosis of isoniazid-resistant and rifampicin-susceptible TB;

(2) low complexity automated NAATs, recommended for the detection of resistance to isoniazid and second-line anti-TB agents, which will improve access to testing of fluoroquinolones resistant at peripheral level; and

(3) high complexity reverse hybridization-based NAATs, recommended for the detection of pyrazinamide resistance, representing the first molecular tests for resistance determination to this drug.

Globally, diagnosis of TB and drug-resistant TB remains a challenge with a third of people with TB and two-thirds of people with drug-resistant TB not being detected.

The use of rapid molecular assays as the initial test to diagnose TB is recommended by WHO instead of sputum smear microscopy as they have high diagnostic accuracy and will lead to major improvements in the early detection of TB and drug-resistant TB.

Accelerated efforts to diagnose TB and drug-resistance are essential to end the global TB epidemic and achieve the targets of the political declaration of the UN high-level meeting.

The WHO End TB Strategy, the UN Sustainable Development Goals, universal health coverage and the triple billion targets of WHO’s General Programme of Work are all frameworks that have been set up to try and end the epidemic.