Addressing the Threat of Drug-Resistant Tuberculosis A Realistic Assessment of the Challenge: Workshop Summary (2009) / Chapter Skim
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4 Diagnosis
4 Diagnosis
Pages 51-58
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From page 51... ...
However, it is expected that the GLI will provide technical assistance and proficiency testing programs to help build this capacity. ACTuAL NEED Current global capacity allows for the conduct of approximately 10 million culture tests for the diagnosis of TB, although much of that capacity is centered in developed countries.
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From page 52... ...
of DST National Laboratories Laboratories Reference per 5 Million per 10 Million Country Laboratory Population Population India Yes 0.03 0.07 China Yes 1.4 2.7 Indonesia No 0.9 1.8 South Africa Yes 1.3 2.7 Nigeria No 0.0 0.0 Bangladesh Yes 0.1 0.2 Ethiopia Yes 0.1 0.1 Pakistan No 0.1 0.2 Philippines Yes 0.2 0.3 Congo Yes 0.1 0.2 Russian Federation No 34 68 Vietnam Yes 1.0 2.1 Kenya Yes 0.3 0.5 Tanzania Yes 0.4 0.8 Uganda Yes 0.5 1.0 Brazil Yes 5.1 10 Mozambique Yes 0.2 0.5 Thailand Yes 5.1 10 Myanmar Yes 0.2 0.4 Zimbabwe Yes 0.4 0.8 Cambodia Yes 1.1 2.1 Afghanistan No 0.2 0.4 NOTE: DST = drug susceptibility testing. SOURCE: Ridderhof, 2008 (based on data from WHO, 2008a, and Stop TB data from Mohamed Abdel Aziz, private communication; used with permission)
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From page 53... ...
Growing evidence indicates high rates of transmission in laboratories performing cultures and DST. Van der Walt discussed South Africa's experience when the country investigated requirements for implementation of the line probe assay for routine diagnosis of MDR TB in 2008.
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From page 54... ...
The GLI's goal is to diagnose 74,000 new MDR TB patients by 2011. A critical component of such an effort is securing sustainable funding from bilateral and multilateral donors to support the construction of incountry DST and rapid testing laboratories, as well as ongoing external quality assessments by supranational reference laboratories.
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From page 55... ...
Postal Service mail sorting centers to detect the presence of bacillus anthracis -- the largest biothreat detection program in the country. To date, more than 7.5 million GeneXpert cartridges have been used to test 100 billion letters, with no false positives.
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From page 56... ...
The technology, developed by the Engelhardt Institute of Molecular Biology in Moscow, is called three-dimensional gel drop arrays, and provides a hydrogel environment. A nano test tube can be loaded with a nucleic acid or an antibody for sample screening and detection.
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From page 57... ...
Funding for TB diagnostics research currently represents only 6 percent of NIH's TB research investment and only 11 percent of its global TB research and development investment. Development of a TB dipstick test will also require a larger effort to identify biomarkers for active disease; platform development; and large, well-characterized clinical specimen banks more widely available than those in use today.
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