Simple Diagnostic Test for TB: Challenges and Possibilities

• Published in: Indian journal of clinical biochemistry 2022-05, Vol.30 (S1), p.S5
• Main Author: Laal, Suman S
• Format: Article
• Language: English
• Subjects: Diagnosis; Drug resistance; Health aspects; Medical tests; Mortality; Tuberculosis
• ISSN: 0970-1915

The last decade has seen the roll-out of several new WHO endorsed tests for diagnosis of TB and drug resistance. Several companies are focusing on the development of new molecular tests that meet or exceed the performance characteristics of GeneXpert but are cheaper and easier to implement. Simultaneously, operational studies provide evidence that only molecular tests that are highly sensitive and specific are unlikely to make a significant impact on patient morbidity and mortality. In recognition of the limitations of bacteriological confirmation, the WHO has identified the urgent need for biomarker-detection based tests for screening for TB, diagnosis of TB and of drug resistance. Unfortunately, few labs or companies have moved towards research or product development for biomarker-based TB tests and the pipeline for such tests is weak. The complexity of the TB spectrum and the various manifestations of TB make it likely that TB control will require multiple comprehensive and cohesive tools. There is an urgent need for clear definition of the potential approaches that can lead to simple tests that can be implemented in TB-endemic countries, and focused efforts in rational development of these tests.