Hanson, Christy and Sotgiu, Giovanni and Loddenkemper, Robert (2014) Ensuring that the diagnosis of tuberculosis accelerates progress towards the Millennium Development Goals. European Respiratory Journal, Vol. 44 (1), p. 1-4. ISSN 0903-1936. eISSN 1399-3003. Article.
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Global tuberculosis control has been riding a wave of progress over the past decade. Mortality and incidence
are now falling in all six World Health Organization (WHO) regions and the tuberculosis-related targets of
the Millennium Development Goals now seem more reachable. This progress reflects important momentum on many fronts, from more systematic community engagement to increased funding availability. Improvements in tuberculosis case detection have been greatly facilitated by the introduction of new diagnostic technologies and approaches. These novel methods are beginning to address clinical, public health and technological challenges, such as diagnosing tuberculosis in people living with HIV, as well as patient barriers to accessing sophisticated technologies and diagnostic results. Prior to 2007, no new diagnostic technologies had been endorsed by WHO in decades. However, in the past 5 years, WHO has evaluated and endorsed six diagnostic technologies and methods. It has refined its
specifications for sputum collection and case identification using smear microscopy, reducing the burden
on patients and laboratory technicians. It has proposed diagnostic algorithms to streamline the concurrent
availability of various technologies and to improve the sensitivity of screening of people living with HIV. In
2011, WHO went so far as to issue negative recommendations on serodiagnostic tests and interferon-c release assays for high-incidence countries], steering national tuberculosis programmes (NTPs) away from diagnostic technologies not yet refined enough to warrant a change in practice.
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