Diagnosis of tuberculosis and drug resistance: what can new tools bring us? [State of the art series. New tools. Number 1 in the series]

• DOI: 10.5588/ijtld.12.0180
• Publication Date: 2012-06-06T13:19:22Z
• Authors: F. Drobniewski; V. Nikolayevskyy; Y. Balabanova; D. Bang; D. Papaventsis
• Keywords: Tuberculosis diagnosis

This is an exciting time for tuberculosis (TB) diagnostics. The technology rapid diagnosis of TB and rifampicin (RMP) resistance in pulmonary sputum smear-positive specimens well advanced, assays have high specificity with good sensitivity. Nevertheless, the current sensitivity detection means that these still cannot replace standard diagnostic methods or conventional drug susceptibility testing (DST). In extra-pulmonary specimens, performance molecular tools varies should be considered separately each specimen type. Evidence use individuals co-infected human immunodeficiency virus (HIV) limited. As positive predictive value RMP reaches ≥ 90% only when prevalence new patients >15%, which rare globally, many cases such will false-resistant, emphasising need a secondary confirmative test. Similarly, increased (or incorrect) may compromise programme effectiveness by increasing numbers requiring anti-tuberculosis treatment, unless it carefully planned. For future, 1) greater are needed; 2) diagnostics paediatric important, there designed studies, including those involving HIV-positive children; 3) more clinical data to obtained from longitudinal especially related influence on disease outcome; 4) point-of-care tests using untreated sputum, blood urine little no equipment would immeasurable benefit. Although great progress has been made, we not yet.