Rapid diagnostics of tuberculosis and drug resistance in the industrialized world: clinical and public health benefits and barriers to implementation
Author(s)
Type
Journal Article
Abstract
In this article, we give an overview of new technologies for the diagnosis of tuberculosis (TB) and drug resistance,
consider their advantages over existing methodologies, broad issues of cost, cost-effectiveness and programmatic
implementation, and their clinical as well as public health impact, focusing on the industrialized world. Molecular
nucleic-acid amplification diagnostic systems have high specificity for TB diagnosis (and rifampicin resistance) but
sensitivity for TB detection is more variable. Nevertheless, it is possible to diagnose TB and rifampicin resistance
within a day and commercial automated systems make this possible with minimal training. Although studies are
limited, these systems appear to be cost-effective. Most of these tools are of value clinically and for public health
use. For example, whole genome sequencing of Mycobacterium tuberculosis offers a powerful new approach to the
identification of drug resistance and to map transmission at a community and population level.
consider their advantages over existing methodologies, broad issues of cost, cost-effectiveness and programmatic
implementation, and their clinical as well as public health impact, focusing on the industrialized world. Molecular
nucleic-acid amplification diagnostic systems have high specificity for TB diagnosis (and rifampicin resistance) but
sensitivity for TB detection is more variable. Nevertheless, it is possible to diagnose TB and rifampicin resistance
within a day and commercial automated systems make this possible with minimal training. Although studies are
limited, these systems appear to be cost-effective. Most of these tools are of value clinically and for public health
use. For example, whole genome sequencing of Mycobacterium tuberculosis offers a powerful new approach to the
identification of drug resistance and to map transmission at a community and population level.
Date Issued
2013-08-29
Date Acceptance
2013-08-02
Citation
BMC Medicine, 2013, 11
ISSN
1741-7015
Publisher
BioMed Central
Journal / Book Title
BMC Medicine
Volume
11
Copyright Statement
© 2013 Drobniewski et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the
Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Subjects
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
MEDICINE, GENERAL & INTERNAL
Diagnosis
Drug resistance
Tuberculosis
Public health
Whole genome sequencing
MEDIATED ISOTHERMAL AMPLIFICATION
MOLECULAR EPIDEMIOLOGIC ANALYSIS
GENOTYPE MTBDRSL ASSAY
XPERT MTB/RIF TEST
LINE-PROBE ASSAY
MYCOBACTERIUM-TUBERCULOSIS
RIFAMPIN RESISTANCE
PULMONARY TUBERCULOSIS
RESPIRATORY SPECIMENS
MULTIDRUG-RESISTANCE
Publication Status
Published
Article Number
ARTN 190