The government has started using tuberculosis diagnosis machine -- GeneXpert -- to detect Covid-19, in a desperate attempt to ease the strain on its testing facilities with limited number of RT-PCR machines.

The testing began on June 24 at the capital's Bangabandhu Sheikh Mujib Medical University (BSMMU) and the National Institute of Diseases of the Chest and Hospital (NIDCH) after international organisation Global Fund supplied 10,000 kits, said officials.

GeneXpert is a portable machine and the test is easy and less time consuming. It takes around 45 minutes to show the results, said the officials, adding that a person's saliva samples are collected with a stick and the stick is then put in the cartridge of the machine for the test.

A PCR test, considered gold standard for Covid-19, needs around four to five hours to show the results. 

The US Food and Drug Administration and the World Health Organisation (WHO) have already approved GeneXpert testing for coronavirus detection, said the officials, adding that Bangladesh currently has 270 GeneXpert machines.

The development came when the country's Covid-19 testing capacity has been extremely insufficient against its huge population. Bangladesh remains at the bottom among the South Asian countries in terms of number of the tests.

Health experts said only one among every 250 people has been tested so far.

According to www.worldometers.info, 4,452 of every one million people of the country have so far been tested, whereas the number is 5,963 in India, 5,611 in Pakistan, and 96,648 in the US.  

On average, Bangladesh is now conducting around 18,000 tests a day with 66 RT-PCR labs. Amid such a low testing capacity, people are suffering. There were instances where individuals had to wait for seven days to get an appointment to get tested.

Talking about GeneXpert, experts said the portable machines could be quite useful in testing Covid-19 in the country's remote areas as well as for emergency patients there.

They said GeneXpert testing is also a real time PCR testing, but it does not need reagents.

According to the National Tuberculosis Control Programme, over 25 lakh TB tests were carried out across the country using GeneXpert in the last four years, and all the machines were functional.

Prof Dr Md Shamiul Islam, line director of TB-Lep, said Global Fund was providing assistance in relation to carrying out coronavirus testing through GeneXpert machines.

"We have already received 10,000 kits and wrote for another 30,000. We will be asking for 70,000 more kits. Apart from this, the government is also considering buying GeneXpert testing kits," he said.

Prof Shamiul said they were planning to scale up the service in 10 hospitals and then in 40 hospitals in phases if the government wants to make it available across the country.

At full capacity, it is possible to conduct over 5,000 test a day, said Prof Shamiul. "It is fast, accurate and less expensive."

"Through this test, we can easily separate Covid-19 and non-Covid-19 patients in hospitals. In emergency cases, this test is very helpful to identify the status of Covid-19 status," he added.

A GeneXpert kit costs around $24 dollars and a PCR test kit $30 dollars without the price of reagents.

ASM Alamgir, principal scientific officer of the Institute of Epidemiology, Disease Control and Research (IEDCR), appreciated the initiative, saying it would bring more people under the testing coverage.

"It is a great tool to reach the remote areas and emergency patients there. And If we can ensure enough cartridge supply, it will reduce the sufferings of people who have to wait for long to get tested and receive test results," he said.

He added that the US, India, and some other countries were already using the machine for the tests.

Nazmul Hasan, assistant professor of BSMMU's internal medicine department, said GeneXpert is handy as it is portable. "It will be extremely helpful at primary health complexes where sample collection is low and places where you need to test a lot of people," he said, adding that a GeneXpert machine is capable of testing four to eight samples at a time.

Jahidur Rahman, virologist and assistant professor at Shahid Suhrawardy Medical College, said, "It is a good initiative and will be very helpful at the upazila level. Another important thing is that operation of the machines is so easy that it does not require any additional manpower support."

Contacted, Abul Kalam Azad, director general of the DGHS, said, "We have started [the testing] on a small scale. We have plans to expand it across the country if we get the cartridges."