Rapid molecular TB diagnosis: evidence, policy making and global implementation of Xpert MTB/RIF
- PMID: 23180585
- DOI: 10.1183/09031936.00157212
Rapid molecular TB diagnosis: evidence, policy making and global implementation of Xpert MTB/RIF
Abstract
If tuberculosis (TB) is to be eliminated as a global health problem in the foreseeable future, improved detection of patients, earlier diagnosis and timely identification of rifampicin resistance will be critical. New diagnostics released in recent years have improved this perspective but they require investments in laboratory infrastructure, biosafety and staff specialisation beyond the means of many resource-constrained settings where most patients live. Xpert MTB/RIF, a new assay employing automated nucleic acid amplification to detect Mycobacterium tuberculosis, as well as mutations that confer rifampicin resistance, holds the promise to largely overcome these operational challenges. In this article we position Xpert MTB/RIF in today's TB diagnostic landscape and describe its additional potential as an adjunct to surveillance and surveys, taking into account considerations of pricing and ethics. In what could serve as a model for the future formulation of new policy on diagnostics, we trace the unique process by which the World Health Organization consulted international expertise and systematically assessed published evidence and freshly emerging experience from the field ahead of its endorsement of the Xpert MTB/RIF technology in 2010, summarise subsequent research findings and guidance on who to test and how, and provide perspectives on scaling up the new technology.
Comment in
-
Ensuring that the diagnosis of tuberculosis accelerates progress towards the Millennium Development Goals.Eur Respir J. 2014 Jul;44(1):1-4. doi: 10.1183/09031936.00028514. Eur Respir J. 2014. PMID: 24982045 No abstract available.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources