Exclusive: Hadassah fights Third World TB epidemic

Israeli experts are examining a "revolutionary" rapid diagnostic test for tuberculosis.

By JUDY SIEGEL-ITZKOVICH
hadassah ein karem 88 (photo credit: )
hadassah ein karem 88
(photo credit: )
Israeli experts have put a "revolutionary" rapid diagnostic test for tuberculosis through its paces, giving the thumbs-up to a kit that could have massive public health implications in the Third World. The test, developed in Peru by Johns Hopkins University scientists, has been found highly reliable and efficient at Hadassah-University Medical Center in Ein Kerem. The diagnostic test would have a major impact, Prof. Shlomo Ma'ayan, director of Hadassah's AIDS Center, told The Jerusalem Post, because the spread of HIV weakens the body's immune system and makes it more susceptible to deadly TB bacterial infection, which kills between 3 and 4 million people around the world each year. Hadassah's clinical microbiology department has just finished holding the first international three-week training session with the test, called microscopic observation direct sensitivity (MODS), for several senior TB lab personnel who came to Jerusalem from Ethiopia. "We have been involved in the fight against AIDS in Ethiopia for many years - not connected with the Jewish and Falash Mura immigration from that country," said Ma'ayan. "Prof. Robert Gilman of Johns Hopkins in Baltimore developed the revolutionary diagnostic tests, which - instead of taking weeks to get the results - does so in five to seven days and uses inexpensive laboratory materials." The test has other advantages as well. "The inexpensive test also tells us whether the strain of tuberculosis bacteria in the patient is sensitive - or resistant - to Isoniazid and Rifampin, the two most effective types of antibiotics given over six to nine months in a drug 'cocktail,'" Ma'ayan said. "If the patient's strain is found to be resistant to these two drugs, second-line medications can be given." Conventional tests until now have not had this ability. Ma'ayan, whose team will travel to Ethiopia next month to help the local AIDS patients and study the local TB diagnostic labs, said that Johns Hopkins lacked the extensive ties with Ethiopia that Hadassah possessed. Therefore, Gilman turned to Hopkins colleague Dr. Henry Kalter, a public health expert who works in Israel, who arranged with the Jerusalem medical center to help oversee the test, which uses a liquid instead of solid medium to culture the TB bacteria along with the antibiotics. Sputum samples from TB patients were brought from Ethiopia to be tested in Jerusalem. "Our plan is to introduce it within the framework of the Israel Consortium on AIDS Medicine in Ethiopia. There, and in the rest of sub-Saharan Africa, South and Central America, Asia and the rest of the Third World, there is giant epidemic of TB because of the immune failure of millions of people," said Ma'ayan. The Baltimore university, whose lab in Lima, Peru, developed the test, asked the Hadassah AIDS Center to help them introduce it to Africa via Ethiopia. Kalter obtained funding through Hopkins's Hecht Foundation for the Hadassah course. Participants in the Hadassah course included Lus Cavietes, chief technician of the Peruvian lab, and Dr. Eshetu Leema, director of the central TB lab in Addis Ababa, who is on sabbatical from the Hebrew University's Kuvin Center for the Study of Infectious and Tropical Diseases under the sponsorship of the Frank Lowey Foundation. Three other technicians from Ethiopia participated in the course as well, which was supervised by Prof. Colin Block, director of Hadassah's clinical microbiology lab. "We hope to get support for this project from the US Centers for Disease Control and Prevention, which is now examining the test, and/or the World Health Organization," Ma'ayan concluded. "We plan to organize further clinical trials in Africa, as the studies so far worked successfully in Central America."