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Advances in tuberculosis diagnostics: the Xpert MTB/RIF assay and future prospects for a point-of-care test

Lawn, Stephen D, Mwaba, Peter, Bates, Matthew, Piatek, Amy, Alexander, Heather, Marais, Ben J, Cuevas, Luis ORCID: https://orcid.org/0000-0002-6581-0587, McHugh, Timothy D, Zijenah, Lynn, Kapata, Nathan, Abubakar, Ibrahim, McNerney, Ruth, Hoelscher, Michael, Memish, Ziad A, Migliori, Giovanni Battista, Kim, Peter, Maeurer, Markus, Schito, Marco and Zumla, Alimuddin (2013) 'Advances in tuberculosis diagnostics: the Xpert MTB/RIF assay and future prospects for a point-of-care test'. Lancet Infectious Diseases, Vol 13, Issue 4, pp. 349-361.

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Abstract

Summary: Rapid progress has been made in the development of new diagnostic assays for tuberculosis in recent years. New technologies have been developed and assessed, and are now being implemented. The Xpert MTB/RIF assay, which enables simultaneous detection of Mycobacterium tuberculosis (MTB) and rifampicin (RIF) resistance, was endorsed by WHO in December, 2010. This assay was specifically recommended for use as the initial diagnostic test for suspected drug-resistant or HIV-associated pulmonary tuberculosis. By June, 2012, two-thirds of countries with a high tuberculosis burden and half of countries with a high multidrug-resistant tuberculosis burden had incorporated the assay into their national tuberculosis programme guidelines. Although the development of the Xpert MTB/RIF assay is undoubtedly a landmark event, clinical and programmatic effects and cost-effectiveness remain to be defined. We review the rapidly growing body of scientific literature and discuss the advantages and challenges of using the Xpert MTB/RIF assay in areas where tuberculosis is endemic. We also review other prospects within the developmental pipeline. A rapid, accurate point-of-care diagnostic test that is affordable and can be readily implemented is urgently needed. Investment in the tuberculosis diagnostics pipeline should remain a major priority for funders and researchers.

Item Type: Article
Subjects: QW Microbiology and Immunology > Bacteria > QW 125 Actinibacteria, Actinomycetales.
QY Clinical Pathology > Diagnostic Tests > QY 120 Sputum
QY Clinical Pathology > QY 25 Laboratory techniques and procedure
WF Respiratory System > Tuberculosis > WF 220 Diagnosis. Prognosis
WX Hospitals and Other Health Facilities > Hospital Administration > WX 162 Point-of-care. Patient care planning.
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1016/S1473-3099(13)70008-2
Depositing User: Martin Chapman
Date Deposited: 08 Dec 2014 13:14
Last Modified: 06 Feb 2018 13:07
URI: http://archive.lstmed.ac.uk/id/eprint/4528

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