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he 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 coronavirus testing in the country. Critics, however, say the government has not been aggressive enough in testing, raising concern that the country has been under-reporting cases.

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 equipped with cartridges that could only detect tuberculous meningitis bacteria and its specimens’ resistance to Rifampicin, an antibiotic to treat several bacterial infections.

Cepheid, the United States-based molecular diagnostics company producing the kits, however, has redesigned its Xpress Flu/RSV cartridges so that they can detect the presence of Severe Acute Respiratory Syndrome coronavirus 2 (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 redesigned cartridges, Faisal told The Jakarta Post recently.

The technology recently received Emergency Use Authorization (EUA) from the US 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 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.

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, the doctor 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.” Fujiwara said in a statement.

Indonesia has so far reported 1,285 coronavirus cases, including 114 that have ended in death.

“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.” 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. (glh)