Tuberculosis diagnostic technology: an African solution … think rats

• Published in: African journal of laboratory medicine 2017-03, Vol.6 (2), p.e1-e4
• Main Authors: Mulder, Christiaan, Mgode, Georgies, Reid, Stewart E.
• Format: Article
• Language: English
• Subjects: Costs; Developing countries; Diagnostics; HIV; Human immunodeficiency virus; Laboratories; LDCs; Light emitting diodes; Microscopy; Mortality; Opinion Paper; Public Health; Scent detection; Tuberculosis
• ISSN: 2225-2002; 2225-2010
• DOI: 10.4102/ajlm.v6i2.420

Introduction Tuberculosis has now gained ranking alongside HIV as one of the two leading causes of death from infectious diseases worldwide.1 In 2014, it was estimated that 1.5 million people died as a result of and 9.6 million fell ill with tuberculosis.1 Despite these alarming figures, efforts to reduce the annual tuberculosis incidence rate over the last decade have resulted in only a meagre 1.5% decline.1 In order to reach the ambitious targets of the Sustainable Development Goals by 2030 of reducing tuberculosis deaths by 90%, reducing the tuberculosis incidence rate by 90%, and ensuring that no tuberculosis-affected family is facing catastrophic costs due to tuberculosis, a paradigm shift is urgently needed.1 Recently, a series of papers was published in The Lancet on how to eliminate tuberculosis, suggesting repacking current interventions into a comprehensive control strategy.2 The World Health Organization End TB Strategy supports this and also emphasises the need for better adoption and rapid uptake of new tools to diagnose tuberculosis earlier, the systematic screening of high-risk populations, and the effective and rapid roll-out of these strategies in highly-affected countries.3 However, the practicality of achieving these components remains challenging because of the lack of a rapid, simple, accurate and affordable point-of-care diagnostic and screening algorithm that can be scaled-up to screen large numbers of individuals. The significant ongoing electricity needs, the variable costs and technological upkeep (maintenance and calibration) pose major barriers for the sustainability of this technology at the point of care in resource-limited settings.7 A full scale-up...