Tuberculosis diagnostics: Challenges and opportunities

Abstract

Tuberculosis (TB) has been a disease affecting almost all parts of the world since ages. Lot many efforts came in the past for improving diagnosis and treatment. Also, an effective vaccine has been sought after for long. With the emergence of resistant strains of Mycobacterium tuberculosis, the causal organisms of tuberculosis, and complexities emerging due to other associated infections and disease conditions, there is a desperate need for further research input in the field. Be it the better medication and care or better resistance management, proper diagnostics holds the key to success. It has been observed that a high burden of the disease was accompanied by resource limitations and poor research set-up. The scenario remained like this for several decades. With the refreshed vision of resourceful countries and funding agencies, funding is being provided in many areas of research in tuberculosis diagnosis and treatment. This review has been written with an aim to bring forth the limitations of available methods in the field of diagnostics and making researchers aware about the changing scenario with better funding opportunities and support. The author visualizes an enthusiasm from all over the world for the development of better modalities and urges scientists to join the struggle at this very perfect time to take the challenge and come forward with innovations in this field.

A pre-clinical validation plan to evaluate analytical sensitivities of molecular diagnostics such as BD MAX MDR-TB, Xpert MTB/Rif Ultra and FluoroType MTB

“…In previous decades, DR-TB mainly resulted from insufficient treatment; however, MDR-TB transmission is long promoting its own pandemic with an estimated 558,000 cases annually [5]. Rapid diagnosis is key to early initiation of effective treatment and to interrupt further spread of resistant TB, but in reality less than a third of MDR-TB cases are detected and therefore not treated [6,7].…”

Paralleling of Diagnostic Endeavor for Control of Mycobacterial Infections and Tuberculosis

“…In addition, DNA isolation, species identification, and obtaining cultures from a sophisticated system may face limitations as well. All these challenges necessitate for advocacy focusing on innovations that deliver better tools to confidently diagnose TB and at affordable costs [71]. Although, international and national laboratory partnerships are encouraged particularly to boost diagnostic services in resource-poor countries, the need for diagnostic tests that allow rapid testing at point-of-care is necessary [72].…”

Imminent Weapons in the Field of Tuberculosis Diagnostics and Management

“…Therefore, WHO had issued certain policy statements for improving diagnosis of TB, including the use of commercial and noncommercial DST methods and implementation of molecular methods such as the Line Probe Assay (LPA) and GeneXpert MTB/RIF? LPA (Genotype MTBDRplus) is a WHO-endorsed test for the rapid detection of MTB-complex and Rifampin (RIF), Isoniazid (INH) resistance in smear-positive sputum specimens with excellent sensitivity and specificity but the use of LPA is currently limited to culture isolates and direct testing of smear-positive sputum specimens [9].…”