Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Nov 28;13(12):1045.
doi: 10.3390/pathogens13121045.

Strategies to Enhance Diagnostic Capabilities for the New Drug-Resistant Tuberculosis (DR-TB) Drugs

Antonia Morita Iswari Saktiawati  1   2 , Anca Vasiliu  3   4   5 , Francesca Saluzzo  6 , Onno W Akkerman  7   8
Affiliations
Review

Strategies to Enhance Diagnostic Capabilities for the New Drug-Resistant Tuberculosis (DR-TB) Drugs

Antonia Morita Iswari Saktiawati et al. Pathogens. .

Abstract

The global burden of drug-resistant tuberculosis (DR-TB) continues to challenge healthcare systems worldwide. There is a critical need to tackle DR-TB by enhancing diagnostics and drug susceptibility testing (DST) capabilities, particularly for emerging DR-TB drugs. This endeavor is crucial to optimize the efficacy of new therapeutic regimens and prevent the resistance and overuse of these invaluable weapons. Despite this urgency, there remains a lack of comprehensive review of public health measures aimed at improving the diagnostics and DST capabilities. In this review, we outline strategies to enhance the capabilities, especially tailored to address the challenges posed by resistance to new DR-TB drugs. We discuss the current landscape of DR-TB drugs, existing diagnostic and susceptibility testing methods, and notable gaps and challenges in these methods and explore strategies for ensuring fair access to DST while narrowing these disparities. The strategies include public health interventions aimed at strengthening laboratory infrastructure, workforce training, and quality assurance programs, technology transfer initiatives, involving drug developers in the DST development, establishing national or regional referral hubs, fostering collaboration and resources pooling with other infection control efforts, extending testing access in underserved areas through public-private partnerships, advocating for lowering costs or loans at low interest, remote technical support, and implementing mandatory molecular surveillance monitoring. This review underscores the urgent need to enhance DST capacities for new DR-TB drugs and identifies opportunities for innovation and improvement. Assessing the extent of the global health impact of these measures is crucial to ensure their effectiveness in combating DR-TB.

Keywords: antitubercular agents; diagnosis; drug resistance; global health; microbial sensitivity tests; tuberculosis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Phenotypic and genotypic tests available for DST.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. World Health Organization . Global Tuberculosis Report 2023. World Health Organization; Geneva, Switzerland: 2023. [(accessed on 5 September 2024)]. Available online: https://iris.who.int/bitstream/handle/10665/373828/9789240083851-eng.pdf....
    1. Dean A.S., Zignol M., Cabibbe A.M., Falzon D., Glaziou P., Cirillo D.M., Köser C.U., Gonzalez-Angulo L.Y., Tosas-Auget O., Ismail N., et al. Prevalence and genetic profiles of isoniazid resistance in tuberculosis patients: A multicountry analysis of cross-sectional data. PLoS Med. 2020;17:e1003008. doi: 10.1371/journal.pmed.1003008. - DOI - PMC - PubMed
    1. World Health Organization . WHO Consolidated Guidelines on Tuberculosis. Module 4: Treatment—Drug-Resistant Tuberculosis Treatment, 2022 Update. World Health Organization; Geneva, Switzerland: 2022. - PubMed
    1. Conradie F., Diacon A.H., Ngubane N., Howell P., Everitt D., Crook A.M., Mendel C.M., Egizi E., Moreira J., Timm J., et al. Bedaquiline, pretomanid and linezolid for treatment of extensively drug resistant, intolerant or non-responsive multidrug resistant pulmonary tuberculosis. N. Engl. J. Med. 2020;382:893. doi: 10.1056/NEJMoa1901814. - DOI - PMC - PubMed
    1. Ahmad N., Ahuja S.D., Akkerman O.W., Alffenaar J.-W.C., Anderson L.F., Baghaei P., Bang D., Barry P.M., Bastos M.L., Behera D., et al. Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: An individual patient data meta-analysis. Lancet. 2018;392:821–834. doi: 10.1016/S0140-6736(18)31644-1. - DOI - PMC - PubMed

MeSH terms

Substances

LinkOut - more resources