UK Nurses Reject Introduction Of 115-Year-Old Tuberculosis (TB) Test

Main Category: Tuberculosis
Also Included In: Nursing / Midwifery
Article Date: 29 Jan 2006 - 11:00 PDT

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Oxford, UK - 70% of TB nurses think the introduction of the outdated Mantoux skin test for detecting latent TB infection is a step backwards, with more than a third believing it is a major setback in the fight against TB, according to a new survey released today. In fact, over half of nurses who currently use the skin test often don't carry it out because they believe the results will be incorrect.

The skin test can give false positive results (diagnosing a patient has TB when in fact they do not, leading to unnecessary and potentially dangerous antibiotic treatment) or give false negative results (not detecting the infection at all, which can be fatal).

The 115-year-old Mantoux skin test has recently been introduced as the standard method for diagnosing latent TB infection in the UK, which has no symptoms and is not infectious but has the potential to develop into TB disease at any time.

While the UK is reverting to one of the world's oldest diagnostic tests, the US has issued new TB detection guidelines, advising that a simple, one-step blood test, can be used in all circumstances under which the traditional tuberculin skin test is currently used.

The majority of UK nurses support this view, with four out of five nurses (82%) with TB testing experience believing a new blood test should be the standard diagnostic tool for latent TB in the UK, and nearly all (95%) of those who have used the blood test would choose it as the standard practice for TB diagnosis.

Ed Vaizey, Conservative MP for Wantage, the constituency in which Oxford Immunotec are based says, 'Over a year ago the Department of Health announced their TB Action Plan, which set out new measures to tackle and ultimately eliminate tuberculosis in England, stating that accurate diagnosis through the use of modern laboratory techniques, is essential. However, by bringing back the Mantoux skin test they are essentially acting directly against the claims they make in their own Plan. The Department of Health needs to start listening to the demands of our nurses in order to control TB in the UK and ultimately, eradicate it.'

Professor Peter Davies, Consultant Chest Physician, Liverpool comments, 'My concern with using the Mantoux skin test is that it can be unreliable, so it is not unusual that an incorrect diagnosis is given. I have come across a number of patients who were initially given a negative result from a skin test, only to later develop TB disease. This is obviously very upsetting and frustrating for the individual and the disease will often have a significant emotional and psychological impact, not to mention the financial implications of taking time off work. With better diagnostic techniques this could be avoided - I believe if a blood test specifically designed for TB diagnosis was available to these patients in the first instance, latent TB infection would have been detected and development of the disease could have been avoided.'

A recent survey conducted by leading research company, IPSOS, reveals the general public are also demanding modern diagnostic tools for TB, with nearly all those surveyed (93%) feeling it important TB is diagnosed as accurately as possible every time, with over three quarters believing the blood test should replace the Mantoux skin test as the standard TB diagnostic tool in the UK.

Latest statistics reveal the number of recorded cases of the disease in the UK has risen by 33% in the last decade to over 7,000 a year. However, up to a further four million people may be infected with latent TB. By accurately diagnosing and treating latent TB, which is easier and more successful to treat than TB disease, the infection can, at last, be effectively controlled.

Oxford-based T cell measurement company, Oxford Immunotec, recently developed a blood test based on revolutionary research at the University of Oxford. The T-SPOT(tm).TB blood test has been shown to have significant advantages over the tuberculin skin test, including superior accuracy, convenience and reliability. Crucially, it is the first test that reliably detects infection in people with weak immune systems.

T-SPOT.TB was licensed in the UK and Europe in July 2004, however the test is currently only available privately and through a handful of NHS hospitals who serve a fraction of the population.

About Oxford Immunotec
www.oxfordimmunotec.com

Oxford Immunotec, the T cell measurement company, is headquartered near Oxford, UK. The Company develops and sells clinical diagnostic products based on its patented T-SPOTTM technology. T-SPOT is a novel platform technology that opens up new ways of diagnosing and monitoring infections by providing a simple and extremely accurate method of studying a person's cellular immune response to an infection. T-SPOT technology can be applied to diagnose and monitor any major disease driven by a T cell response.

Oxford Immunotec's first product is T-SPOT.TB, a revolutionary new in vitro (outside the body) diagnostic test for tuberculosis infection, recently approved for sale in Europe. It is designed to replace the tuberculin skin test for the diagnosis of latent TB infection. T-SPOT.TB allows the reliable screening and early detection of latent TB infection (which allows treatment before the infection can be transmitted to others) and will bring TB testing to many new patient groups where the skin test gives poor or un-interpretable results. T-SPOT.TB offers a substantially more accurate and effective tool for controlling the spread of TB. The T-SPOT.TB test has been tested in 31 clinical studies, involving over 5,000 patients in 11 different countries, in both the developed and developing world. There are 18 published studies with more than ten new manuscripts in preparation.

Cost Effective

T-SPOT(tm).TB is the most effective strategy in improving the health-related wellbeing of potential TB patients and when all costs are considered, is the least expensive strategy according to the York Health Economics Consortium on TB testing, 2005. Effective TB control using the blood test costs �47 per patient per year, which is �20 less than not screening at all and for every additional case of TB averted, the blood test saves �7,000 compared to the skin test.

Award Winning

In November 2005, Oxford Immunotec's T-SPOT.TB blood test won the prestigious Equinox-sponsored award for the Best Business Proposition at the Medical Futures Innovation Awards. The awards, which celebrate the best of British healthcare, attracted 1,200 entries and were judged by a high profile panel including Dame Carol Black, the President of the Royal College of Physicians and Professor Aidan Halligan, the NHS Director of Clinical Governance. The awards are designed to encourage and promote a culture of creativity, innovation and leadership among healthcare professionals and facilitate the successful commercialisation of these ideas. Oxford Immunotec's award underlines the market potential for T-SPOT.TB.

About the TB Nurses Survey

Oxford Immunotec commissioned Aline Beresford, an independent research consultant, to conduct a survey to gain a greater understanding of their experiences and opinions regarding the diagnosis of latent tuberculosis infection in the UK. A total of 165 nurses (TB specialist nurses and practice nurses) were surveyed across the UK during November 2005.

Oxford Immunotec
www.oxfordimmunotec.com

SOURCE: www.virgohealthpr.com

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