Tuberculosis diagnosis: Challenges and solutions

More than 9 million people develop tuberculosis (TB) every year, but nearly a third are not diagnosed or not reported. The current diagnostic tools available range from a 100-year-old microscopy technique to the newest generation automated nucleic acid amplification tests, but they alone are not sufficient to ensure that we meet the goals of the end TB strategy. Several new TB tests are under development. As new diagnostics are developed, it is critical that we understand the particular challenges that arise in TB diagnosis, and ensure that existing tools are implemented correctly. We must encourage the development of diagnostics that meet the specific needs of the TB community as well as ensuring that new technologies are accessible to low- and middle-income countries. Finally, strong policy guidance is required to ensure that new and existing diagnostics are used as efficiently as possible. With this co-ordinated approach, new diagnostic tools can be the cornerstone of the effort to end TB.