The Indonesian Society of Respirology (PDPI) has said diagnostic test kits for tuberculosis could be modified and used for COVID-19, but that it is up to the government if it wants to employ the device to fight the deadly disease.

The government has so far used polymerase chain reaction (PCR) tests and antibody test kits for the coronavirus testing in the country. Critics, however, say the government has not been aggressive enough in conducting the testing, raising speculations that the country has been under-reporting cases.

Dr. Faisal Yunus, a member of the PDPI advisory board, said doctors in Indonesia had always conducted rapid molecular tests to detect tuberculosis using the diagnostic kits, called Xpert TBM/RIF. In the past, the doctor said, those kits were only equipped with cartridges that could only detect tuberculosis meningitis bacteria and its specimens’ resistance to Rifampicin, an antibiotic to treat several bacterial infections.

Cepheid, the US-based molecular diagnostics company producing the kits, however, has redesigned its Xpress Flu/RSV cartridges so that they can detect the presence of SARS-CoV-2, the virus causing the deadly COVID-19 disease.

In other words, regular tuberculosis diagnostic machines in Indonesia could now detect COVID-19 if only their cartridges were replaced with the new redesigned cartridges, Faisal told The Jakarta Post recently.

The technology recently received Emergency Use Authorization (EUA) from the United States Food and Drug Administration (FDA), meaning that those kits are approved to run COVID-19 tests in the US.

Faisal argued that this new development could help Indonesia to expedite its COVID-19 detection, considering that the country had around 765 Xpert TBM/RIF machines scattered across 742 health facilities in 438 regencies and cities, according to 2018 Health Ministry data.

It is unclear, however, how much the test would cost in Indonesia. According to stoptb.org, the market price for an Xpert TBM/RIF cartridge for tuberculosis, not Sars-Cov-2, ranges from US$55 (about Rp 881,000) to $82.

The International Union Against Tuberculosis and Lung Disease, which has already endorsed Xpert tuberculosis diagnostic kits as platforms to test COVID-19, believes that the technology can accelerate the detection of the disease in low- and middle-income countries.

Dr. Paula Fujiwara, the scientific director of the union, said that people could easily access the test as around 23,000 Cepheid test kits had been used by many clinical laboratories across the globe. The new Cepheid technology, she said, could also return results in only 45 minutes.

However, she still raised concerns over the price of the test, which was currently $20 per test, but recent analysis by international humanitarian organization Doctors Without Borders provided a cogent argument that the price of the test could be reduced to approximately $5 per test.

“Adapting the same platform for use with COVID-19 could be easily and rapidly done. The need for testing is immense as we still don’t know the true number of people who are infected in the world,” Fujiwara said in a statement.

Faisal, however, doubted that the government would take the initiative, saying that it had not been aggressive enough in conducting the testing for COVID-19. He argued that the high death rate of COVID-19 in Indonesia might indicate that the number of people infected by the disease was much higher.

Indonesia has so far reported 1,046 coronavirus cases with 85 deaths.

“This leads us to the real question: Is the government willing to take this effort? Because replacing cartridges is not free, we have to buy them from the producer. And I still have no idea about the price of those cartridges,” Faisal said.

The Post contacted the head of Indonesia’s COVID-19 rapid response task force Doni Monardo to ask whether the government would use tuberculosis test kits for the COVID-19 rapid tests, but he referred the Post’s inquiry to the Health Ministry.

Health Ministry disease control and prevention director general Achmad Yurianto didn’t respond to the Post’s messages and phone calls as of Thursday evening.

As of Tuesday, the government claimed to have distributed 125,000 test kits to 34 provinces across the country to battle the outbreak. (glh)