System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Review Ppublish 59 citations

PubMed: 35339423 DOI: 10.1016/j.ebiom.2022.103939

Reimagining the status quo: How close are we to rapid sputum-free tuberculosis diagnostics for all?

EBioMedicine 78:103939

Authors: Ruvandhi R Nathavitharana, Alberto L Garcia-Basteiro, Morten Ruhwald, Frank Cobelens, Grant Theron

Affiliations

  • Division of Infectious Diseases, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston, USA.
  • ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saude de Manhiça, Maputo, Mozambique.
  • FIND, the global alliance for diagnostics, Geneva, Switzerland.
  • Department of Global Health and Amsterdam Institute for Global Health and Development, Amsterdam University Medical Centers, Amsterdam, Netherlands.
  • DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.

Abstract

Rapid, accurate, sputum-free tests for tuberculosis (TB) triage and confirmation are urgently needed to close the widening diagnostic gap. We summarise key technologies and review programmatic, systems, and resource issues that could affect the impact of diagnostics. Mid-to-early-stage technologies like artificial intelligence-based automated digital chest X-radiography and capillary blood point-of-care assays are particularly promising. Pitfalls in the diagnostic pipeline, included a lack of community-based tools. We outline how these technologies may complement one another within the context of the TB care cascade, help overturn current paradigms (eg, reducing syndromic triage reliance, permitting subclinical TB to be diagnosed), and expand options for extra-pulmonary TB. We review challenges such as the difficulty of detecting paucibacillary TB and the limitations of current reference standards, and discuss how researchers and developers can better design and evaluate assays to optimise programmatic uptake. Finally, we outline how leveraging the urgency and innovation applied to COVID-19 is critical to improving TB patients' diagnostic quality-of-care.

MeSH

Biomedical Research, Triage, Sputum, Tuberculosis

Cited by