Innovative laboratory methods for improved tuberculosis diagnosis and drug-susceptibility testing

Nathan Mugenyi, Nelson Ssewante, J. Baruch Baluku, F. Bongomin, Mutuku Mukenya Irene, Alfred Andama, Pauline Byakika-Kibwika
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Abstract

The laboratory plays a vital role in the diagnosis of all clinical forms of tuberculosis (TB), from microbiological confirmation of Mycobacterium tuberculosis to drug-susceptibility testing (DST) and treatment monitoring. For many decades, laboratory diagnosis of tuberculosis was based on conventional methods such as smear microscopy, and culture-based methods. However, Mycobacterium tuberculosis is a slow-growing organism, requiring 2–4 weeks or longer for cultures to yield results. Therefore, the evaluation of novel and rapid diagnostic methods has been a priority for research and development. In the beginning of 1990s, molecular-based diagnostics became widely available providing rapid detection, identification, and DST of M. tuberculosis. In this paper, we review some of the new diagnostic methods introduced in the clinical laboratory for the diagnosis of tuberculosis. With the global goal of ending TB as a public health challenge by 2030, enhancing diagnostic capabilities for latent and active TB, along with improving DST, would improve identification and management of cases, reducing transmission rates and curbing the spread of drug-resistant strains. These innovations promise to transform TB control efforts, bringing us closer to eradicating this persistent global health threat.
改进结核病诊断和药敏试验的创新实验室方法
从结核分枝杆菌的微生物学确诊到药物敏感性测试(DST)和治疗监测,实验室在所有临床形式的结核病(TB)诊断中发挥着至关重要的作用。几十年来,结核病的实验室诊断一直基于传统方法,如涂片显微镜检查和基于培养的方法。然而,结核分枝杆菌是一种生长缓慢的生物,需要 2-4 周或更长时间的培养才能得出结果。因此,对新型快速诊断方法的评估一直是研发工作的重点。20 世纪 90 年代初,以分子为基础的诊断方法开始广泛应用,可对结核杆菌进行快速检测、鉴定和 DST。在本文中,我们回顾了临床实验室用于诊断结核病的一些新诊断方法。全球的目标是到 2030 年不再将结核病作为一项公共卫生挑战,因此,提高对潜伏和活动性结核病的诊断能力,同时改进 DST,将改善对病例的识别和管理,降低传播率并遏制耐药菌株的传播。这些创新有望改变结核病控制工作,使我们更接近根除这一持续存在的全球健康威胁。
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