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Implementing molecular tuberculosis diagnostic methods in limited-resource and high-burden countries

Tuberculosis (TB) is one of the deadliest infectious diseases in the world with more than a million people dying of TB each year. Accurate and timely TB diagnosis has the potential to alleviate the global TB burden; therefore, one of the pillars of the End TB Strategy developed by the World Health O...

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Autores principales: Vasiliu, Anca, Saktiawati, Antonia Morita Iswari, Duarte, Raquel, Lange, Christoph, Cirillo, Daniela Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Respiratory Society 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9973455/
https://www.ncbi.nlm.nih.gov/pubmed/36865933
http://dx.doi.org/10.1183/20734735.0226-2022
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author Vasiliu, Anca
Saktiawati, Antonia Morita Iswari
Duarte, Raquel
Lange, Christoph
Cirillo, Daniela Maria
author_facet Vasiliu, Anca
Saktiawati, Antonia Morita Iswari
Duarte, Raquel
Lange, Christoph
Cirillo, Daniela Maria
author_sort Vasiliu, Anca
collection PubMed
description Tuberculosis (TB) is one of the deadliest infectious diseases in the world with more than a million people dying of TB each year. Accurate and timely TB diagnosis has the potential to alleviate the global TB burden; therefore, one of the pillars of the End TB Strategy developed by the World Health Organization (WHO) is the early diagnosis of TB, including universal drug-susceptibility testing (DST). The WHO emphasises the importance of DST before treatment initiation, using molecular WHO-recommended rapid diagnostic tests (mWRDs). Currently available mWRDs are nucleic acid amplification tests, line probe assays, whole genome sequencing, and targeted next-generation sequencing. However, implementing the sequencing mWRDs in routine laboratories in low-income countries is constrained by the existing infrastructure, high cost, the specialised skills needed, data storage, and the current delay in results compared with other routine methods. These limitations are pronounced in resource-limited settings, which often have a high TB burden and need for innovative TB diagnostic technologies. In this article we propose several possible solutions, like adapting infrastructure capacity to needs, advocating for lowering costs, building bioinformatics and laboratory capacity, and increasing the use of open-access resources for software and publications.
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spelling pubmed-99734552023-03-01 Implementing molecular tuberculosis diagnostic methods in limited-resource and high-burden countries Vasiliu, Anca Saktiawati, Antonia Morita Iswari Duarte, Raquel Lange, Christoph Cirillo, Daniela Maria Breathe (Sheff) Viewpoint Tuberculosis (TB) is one of the deadliest infectious diseases in the world with more than a million people dying of TB each year. Accurate and timely TB diagnosis has the potential to alleviate the global TB burden; therefore, one of the pillars of the End TB Strategy developed by the World Health Organization (WHO) is the early diagnosis of TB, including universal drug-susceptibility testing (DST). The WHO emphasises the importance of DST before treatment initiation, using molecular WHO-recommended rapid diagnostic tests (mWRDs). Currently available mWRDs are nucleic acid amplification tests, line probe assays, whole genome sequencing, and targeted next-generation sequencing. However, implementing the sequencing mWRDs in routine laboratories in low-income countries is constrained by the existing infrastructure, high cost, the specialised skills needed, data storage, and the current delay in results compared with other routine methods. These limitations are pronounced in resource-limited settings, which often have a high TB burden and need for innovative TB diagnostic technologies. In this article we propose several possible solutions, like adapting infrastructure capacity to needs, advocating for lowering costs, building bioinformatics and laboratory capacity, and increasing the use of open-access resources for software and publications. European Respiratory Society 2022-12 2023-02-14 /pmc/articles/PMC9973455/ /pubmed/36865933 http://dx.doi.org/10.1183/20734735.0226-2022 Text en Copyright ©ERS 2023 https://creativecommons.org/licenses/by-nc/4.0/Breathe articles are open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
spellingShingle Viewpoint
Vasiliu, Anca
Saktiawati, Antonia Morita Iswari
Duarte, Raquel
Lange, Christoph
Cirillo, Daniela Maria
Implementing molecular tuberculosis diagnostic methods in limited-resource and high-burden countries
title Implementing molecular tuberculosis diagnostic methods in limited-resource and high-burden countries
title_full Implementing molecular tuberculosis diagnostic methods in limited-resource and high-burden countries
title_fullStr Implementing molecular tuberculosis diagnostic methods in limited-resource and high-burden countries
title_full_unstemmed Implementing molecular tuberculosis diagnostic methods in limited-resource and high-burden countries
title_short Implementing molecular tuberculosis diagnostic methods in limited-resource and high-burden countries
title_sort implementing molecular tuberculosis diagnostic methods in limited-resource and high-burden countries
topic Viewpoint
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9973455/
https://www.ncbi.nlm.nih.gov/pubmed/36865933
http://dx.doi.org/10.1183/20734735.0226-2022
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