Molecular diagnosis of tuberculosis: we need solutions that span the healthcare value chain

MacLean, Emily; Huddart, Sophie; Pai, Madhukar

doi:10.1080/14737159.2017.1265889

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…24 Gaps in service delivery must be addressed across the entire health care value chain, of which diagnostics play a big role. 25 The use of molecular technologies is contributing toward the 1.9% annual decline in TB incidence 24 by providing earlier diagnosis of TB disease. This is evident from the recent meta-analysis, 26 showing the plausible reduction in 6-month all-cause mortality estimate at 12%, associated with the use of Xpert MTB/RIF as the initial diagnostic test for pulmonary TB.…”

Section: Discussionmentioning

confidence: 99%

Performance of the Roche cobas MTB Assay for the Molecular Diagnosis of Pulmonary Tuberculosis in a High HIV Burden Setting

Scott

David

Govender

et al. 2020

The Journal of Molecular Diagnostics

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Section: Discussionmentioning

confidence: 99%

Performance of the Roche cobas MTB Assay for the Molecular Diagnosis of Pulmonary Tuberculosis in a High HIV Burden Setting

Scott

David

Govender

et al. 2020

The Journal of Molecular Diagnostics

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“…Adequate linkages between levels are required, including sample transport and patient referral systems, diagnostic connectivity, and information and communication technologies that can notify patients and physicians of test results and facilitate timely linkages to care. 32 Lack of such integration causes large losses during the cascade of care (Figure 2).…”

Section: Role Of Improved Diagnosismentioning

confidence: 99%

What will it take to eliminate drug-resistant tuberculosis?

Kendall

Sahu²,

Pai

et al. 2019

int j tuberc lung dis

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Summary Drug resistant tuberculosis (DR-TB) is challenging to diagnose, treat, and prevent, but that is slowly changing. If the world is to drastically reduce the incidence of DR-TB, we must stop creating new drug-resistant TB as an essential first step. The drug-resistant TB epidemic that is ongoing must also be directly addressed. First-line drug resistance must be rapidly detected through universal molecular testing for resistance to at least rifampin and preferably other key drugs at initial TB diagnosis. DR-TB treatment outcomes must also improve dramatically. Effective use of currently-available, new, and repurposed drugs, combined with patient-centered treatment that aids adherence and reduces catastrophic costs, are essential. Innovations within sight, such as short, highly-effective, broadly-indicated regimens, paired with point-of-care drug susceptibility tests, could accelerate progress in treatment outcomes. Preventing or containing resistance to second-line and novel drugs is also critical and will require high-quality systems for diagnosis, regimen selection, and treatment monitoring. Finally, earlier detection and/or prevention of DR-TB is necessary, with particular attention to airborne infection control, case finding, and preventive therapy for contacts of patients with DR-TB. Implementing these strategies can overcome the barrier that DR-TB represents for global TB elimination efforts, and could ultimately make global elimination of DR-TB (fewer than one annual case per million population worldwide) attainable. There is a strong cost-effectiveness case to support pursuing DR-TB elimination, but achieving this goal will require substantial global investment plus political and societal commitment at the national and local levels.

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“…In terms of laboratory requirements, MinION is more easily transportable and requires less lab space (24,25) but still requires human intervention for sample preparation. Thus, regardless of the next-generation sequencing platform used, most of the required resources are currently available only in a reference laboratory setting, prohibiting the decentralization of WGS for TB diagnostics (26).…”

mentioning

confidence: 99%