Improving tuberculosis diagnosis in Cameroon: TB-LAMP - a new molecular diagnostic tool for remote settings will be rolled out in Cameroon
Tuberculosis is the most common cause of death among infectious diseases and affects around 11 million people worldwide every year. The global "end- TB strategy" with its 90-(90)-90 targets aims to reach at least 90% of people with tuberculosis, including the main and vulnerable populations, receive adequate treatment and ensure that at least 90% of treatments are successfully completed. An important lever to achieve this is the access to fast and reliable diagnosis.
According to the World Health Organization**, there are 49,000 cases of tuberculosis in Cameroon, of which only 25,000 have been diagnosed. The reasons for this are the low sensitivity of conventional diagnostic methods (e.g. smear microscopy) respectively the high demands on the infrastructure when using more sensitive molecular methods. However, a large number of TB patients live in remote regions with little infrastructure.
Therefore, a pilot project was set up using TB-LAMP, a new, robust and easy-to-use molecular assay for the detection of TB. In 2017, under the direction of the National Tuberculosis Program, the assay was tested with regard to sensitivity and practicability in 4 hospitals with 3 in remote areas.
Following the promising results of the pilot project, the government of Cameroon decided to introduce this technology in the country.
Global Fund partnership and many proponents
Cameroon then applied for a grant from the Global Fund, which was approved at the beginning of 2018. Cameroon is the first country in Africa which will implement TB-LAMP on a broad base and therefore enable fast and reliable diagnosis especially in remote settings.
To communicate this new approach the National TB Program and the Centre Pasteur as National TB reference Laboratory held an international meeting in Yaoundé on "Improving tuberculosis diagnosis in Cameroon: the place of molecular diagnostic tools" on the occasion of the 25th World TB Day (22 March). More than 120 participants, including the representative of the Minister of Health, the Director of the Centre Pasteur of Cameroon, the National TB program coordinators and representatives of other countries like Chad, DR Congo and Ivory coast took part in this event. Also present were Japanese Ambassador Mr. Okamura, representative of the management of Eiken Chemical and HUMAN and numerous representatives of the media.
After introductory words by Dr. Vincent Mbassa, permanent secretary of the National TB Program, Dr. Valerie Donkeng (Scientific Coordinator of TB LAMP implementation, Centre Pasteur of Cameroon) presented the TB-LAMP technique and explained the national TB-LAMP implementation plan. “I am very hopeful that TB-LAMP can contribute to a significant improvement in tuberculosis diagnostic”, mentioned Dr. Valerie Flore Donkeng Donfack.
Her presentation was followed by Dr. Lot Kengne (Head of Laboratory of the regional hospital in Ebolowa), where one of TB LAMP equipment was set up, who showed that the use of TB-LAMP led to a significantly higher detection rate of TB patients. The highlight of the event was the official handover of the HumaLoop T-Instrument to one of the hospitals at the Center Region, which will begin with the molecular diagnosis of TB with TB-LAMP. The official part was concluded by the speech of Prof. Sinata Koulla Shiro, Secretary General of the Ministry of Health, representing the Ministry of Health unable to attend who once again emphasized the full commitment of MOH Cameroon to the fight against tuberculosis.
The TB-LAMP solution, developed by HUMAN´s partner Eiken Chemical Co., Ltd., is a molecular method for the detection of Mycobacterium Tuberculosis Complex. Its robustness, high sensitivity and ease of use makes LAMP an excellent and nearly failsafe solution to improve TB diagnostics in remote areas. Moreover, this system offers a higher throughput of samples in lesser time than existing technologies (1-2 hrs for 14 samples, 56 samples/ day/ equipment). In 2016, WHO* recommended that smear microscopy may be replaced by TB-LAMP. TB-LAMP is also included in the Global Drug Facility (GDF) catalog (http://stoptb.org/gdf/drugsupply/drugs_available.asp) and in the list of WHO recommended diagnostic tool 2018.
For more information about TB-LAMP visit us at www.human.de/lamp.
* WHO Policy Guidance. The use of TB-LAMP for the diagnosis of pulmonary tuberculosis. August 2016
** WHO tuberculosis country profiles; http://www.who.int/tb/country/data/profiles/en/
Pictures: Georges Marcel Nyamoutet