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In the meantime WHO has issued a Rapid Communication on the use of Molecular Assays as initial tests for
the diagnosis of tuberculosis and rifampicin resistance.2Rapid Communication: Molecular assays as initial
tests for the diagnosis of tuberculosis and rifampicin resistance, 2020,
https://apps.who.int/iris/handle/10665/330395
Key Findings
The performance of Truenat MTB, MTB Plus and MTB-RIF Dx assays show comparable accuracy to the Xpert
MTB/RIF and the Xpert Ultra for TB detection (Truenat MTB and Truenat MTB Plus) and for sequential
rifampicin resistance detection (Truenat MTB-Rif Dx).
The Truenat MTB and MTB Plus assays also show comparable accuracy to the TB-LAMP assay as replacement
tests for sputum smear microscopy. The data for Truenat MTB-Rif shows similar accuracy to WHO-approved
commercial line probe assays.
Dr Balram Bhargava, the Director General of the Indian Council of Medical Research, said that this endorsement
of the technology by WHO would enable low and middle income countries to procure TrueNat for tuberculosis
diagnosis and Rifampicin resistance, so supporting the elimination of the disease in developing
countries.3WHO endorses tech developed by Indian scientists to detect TB, multi-drug resistant TB, 2020,
https://health.economictimes.indiatimes.com/news/diagnostics/who-endorses-tech-developed-by-indian-
scientists-to-detect-tb-multi-drug-resistant-tb/73298950
WHO also said that the evidence reviewed supported the continued use of Xpert MTB/RIF and Xpert Ultra as
initial diagnostic tests for pulmonary TB in patients of all ages.
Who has developed the TrueNat TB test?
The TrueNat test has been developed by the Indian firm MolBio Diagnostics Pvt Ltd Goa. It’s development has
been funded by Bigtec Labs, India.
With this test samples can be tested as soon as a patient with symptoms of TB is seen. As the entire set-up is
both battery operated and portable, it can be used at the most basic parts of the health care system. This is
where this test differs from GeneXpert. GeneXpert is most suitable for being used where several tests can be
done at the same time.
The standard smear microscopy test has limitations. It usually finds it difficult to diagnose TB when the
bacterial load is less than 10,000 per millilitre of the sputum sample, giving erroneus negative results for some
patients. 4Mudur, G. S. “One-hour test for TB”,
https://www.telegraphindia.com/india/one-hour-test-for-tb-183556
The machine looks for the DNA specific to the TB bacteria. If the
machine detects it, it then uses PCR to copy (amplify) small
segments of DNA and this DNA can then be used in many different
laboratory procedures.
The Genexpert is designed for larger volumes and needs a reliable electricity supply.
“We are not going to replace GeneXpert. We are planning to take Truenat MTB to the
primary health centre level, which cannot be done using GeneXpert as it needs
uninterrupted power supply and air conditioning.
Dr Swaminathan, Director-General of ICMR
How far advanced is the testing of the TrueNat?
A preliminary test in 2013
In a preliminary test carried out on 191 patient samples in 2013, the sensitivity (ability of a test to correctly
identify those with the disease) of TrueNat was found to be over 91% and the specificity (ability of the test to
correctly identify those without the disease) was 100%.6“Rapid diagnosis of Mycobacterium tuberculosis with
Truenat MTB: A Near-Care Approach”, Plos One, 2013,
http://journals.plos.org/ It was concluded that:
“the TrueNat MTB test not only has good sensitivity and specificity for the diagnosis
of TB but also fits the requirements of the resource limited settings. Large studies are
required to obtain better estimates of the TrueNat MTB performance.”
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This page was last updated in January 2020.
Author Annabel Kanabus
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Genexpert Tests TB TB
Kanabus
Citation : Kanabus,
Annabel “Information
about Tuberculosis”,
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