A facemask being tested by the NHS can diagnose tuberculosis early.
The gadget, designed with the help of British scientists, can detect disease bacteria expelled by a suspected patient’s mouth after they wear it for just half an hour.
Researchers say the ‘world-changing’ technology could save millions of lives a year by giving a rapid diagnosis.
In a study of tuberculosis (TB) patients, the mask correctly identified the life-threatening disease 86 per cent of the time.
This compared with 20 per cent from a typical diagnostic tool which involves taking a sample of phlegm from inside the lungs, which is not always reliable.
The mask is now being trialled at an NHS TB service in Leicester, and is expected to save thousands of pounds in cost if it is rolled out nationwide.
TB is one of the top ten leading causes of death globally, killing a total of 1.5million in 2018. Some 6,000 in the UK fall ill with TB every year.
A facemask being tested by the NHS can diagnose tuberculosis early. The gadget, designed with the help of British scientists, contains strips of polyvinyl alcohol (arrows) which collect disease bacteria expelled by a suspected patient’s mouth after they wear it for just half an hour
The researchers at the University of Leicester and the University of Pretoria designed 3D printed strips of polyvinyl alcohol that are inserted into the mask.
The strips can reliably capture bacteria the causes TB when a person with symptoms breathes, coughs or talks.
After 30 minutes, the strips can be tested in a laboratory with results coming back within half a day.
Diagnostic tests for TB may involve a blood test, chest x-ray, and in some cases a bronchoscopy.
Many countries still rely on a long-used method called sputum smear microscopy, when phlegm samples from the lungs are analysed under a microscope.
But microscopy only detects half the number of TB cases and cannot detect drug-resistance TB, the World Health Organization (WHO) says.
Because TB often takes a while to develop, a person with symptoms may have had the infection in their body for weeks already, spreading to others, before a test picks it up.
Professor Mike Barer at the University of Leicester said: ‘This is the first time that exhalation from prospective patients with TB can be captured in such a quick and simple way.
The researchers at the University of Leicester and the University of Pretoria designed 3D printed strips of polyvinyl alcohol that are inserted into the mask (pictured)
After 30 minutes, the strips can be tested in a laboratory (pictured)
HOW IS TUBERCULOSIS CURRENTLY DIAGNOSED?
Common symptoms of active lung TB are cough with sputum and blood at times, chest pains, weakness, weight loss, fever and night sweats.
Many countries still rely on a long-used method called sputum smear microscopy to diagnose TB.
Trained laboratory technicians look at samples of sputum – mucus from the lungs – under a microscope to see if TB bacteria are present. Microscopy detects only half the number of TB cases and cannot detect drug-resistance.
An X-ray may be used to look for changes in appearance that suggests pulmonary TB, which affects the lungs.
TB outside of the lungs can be picked up with scans such as CT and MRI, a urine or blood test, or biopsy. A patient may also have to endure a lumbar puncture, when fluid is taken from the spine with a needle.
The use of the rapid test Xpert MTB/RIF®. which looks at DNA, has expanded substantially since 2010, when WHO first recommended its use.
The test simultaneously detects TB and resistance to rifampicin, the most important TB medicine.
Diagnosis can be made within two hours and is advised as a first-line diagnostic tool for anyone with TB symptoms.
Tests for latent TB, which is when a person is infected with TB but not showing symptoms, may be given the Mantoux test, which involves injecting a small amount of a substance into the skin of the skin and seeing if the TB reacts to it, causing a lump.
‘This pioneering research provides the opportunity to save thousands of lives every year across the world by early detection of a treatable disease – it’s world-changing.
‘The fact that the mask is a low cost and more accurate option for detecting live TB before it appears in sputum has huge implications for early detection of the disease and patients having earlier access to treatment.
‘We are really excited about how we can take this forward and influence the spread of airborne infection.’
It costs the NHS £1.8m annually to test for TB in adults, according to data from the National Institute of Care and Excellence.
In comparison, the mask insert materials cost around £2 to print, potentially saving thousands of pounds for the NHS.
The mask is being tested by NHS TB services in Leicester and is due to be introduced in two other hospitals in six months, The Times reports.
Promising results of a separate study were published in The Lancet yesterday. The teams initially sampled 24 people with confirmed TB during a 24 hour period.
By looking at bacteria in the marks, they found infectious TB was exhaled and spread when patients were asleep.
This ‘breakthrough’ in understanding of the disease suggests a cough may not be required to spread the infection.
Findings show 86.5 per cent of the patients testing positive for TB through the use of the mask, and only 20.5 per cent from sputum – mucus taken from the lungs.
In addition, a further trial of 20 patients with TB symptoms, four patients with negative sputum tested positive with the mask, and the presence of TB was only detected in their sputum six weeks later.
The study demonstrated how the mask is more consistent at spotting TB, and could ensure earlier diagnoses.
It could reduce spread to others because it can accurately detect TB quicker, and could spell the end of invasive procedures.
Professor Barer continued: ‘The mask insert has the potential to save millions of lives globally, being easily accessible and cost effective to produce.’
The World Health Organization wants the number of new cases of TB each year to be cut by 90 per cent, and deaths by 95 per cent, by 2035.
There were an estimated 10million new TB cases and 1.5million deaths attributed to the killer disease across the world in 2018.
Eight countries account for two thirds of the total cases, with India leading the count, followed by China.
There were an estimated 10million new tuberculosis cases and 1.5million deaths attributed to tuberculosis in 2018. Some have multidrug-resistant tuberculosis (MDR), which is when the bacteria does not respond to the most powerful drugs. Most cases of TB are in India
WHAT IS TUBERCULOSIS AND IS IT MAKING A COMEBACK IN BRITAIN?
Tuberculosis (TB) is a bacterial infection spread between people by coughing and sneezing.
The infection usually affects the lungs but the bacteria can cause problems in any part of the body, including the abdomen, glands, bones and the nervous system.
At the beginning of the 19th century, TB killed at least one in seven people in England. But today – thanks to improvements in health, faster diagnoses and effective antibiotics – less than six per cent of those with TB are killed by the disease, with just under 4,672 cases reported in the UK in 2018.
Despite these improvements, in 2010 a report into TB in London and Britain as a whole found that the number of cases in the capital had risen by almost 50 per cent from 1999.
Professor Alimuddin Zumla of University College London attributed the rise to people living under ‘Victorian’ conditions, with poor housing, inadequate ventilation and overcrowding in certain deprived areas of London.
He also said the increase in TB cases was predominantly among people born outside Britain, but who appear to have been infected in the UK, rather than in their country of origin.
The infection usually affects the lungs but the bacteria can cause problems in any part of the body, including the abdomen, glands, bones and the nervous system
TB infection causes symptoms like fever, coughing, night sweats, weight loss, tiredness and fatigue, a loss of appetite and swellings in the neck.
If the immune system fails to contain TB bacteria the infection can take weeks or months to take hold and produce symptoms, and if it is left untreated it can be fatal.
TB is most common in less developed countries in sub-saharan and west Africa, southeast Asia, Russia, China and South America.
Researchers in Wales said that of those infected with this disease in 2017, 55 per cent were born outside the UK.
Although, 20 per cent had at least one of the following social risk factors:
- Being in prison
- IV drug use
- Poor housing or homelessness