Cheap reliable diagnosis for tuberculosis urgently needed

8 January 2009

Undetected tuberculosis is a serious threat to world health and a cheap reliable diagnosis is urgently needed. This was the outcome of the EAGLES International Symposium report on Tuberculosis Research, held in Shenzhen, China, in November 2008.

It concluded that TB is the most important infectious disease in China and that millions of people from Asia, South America and Africa are carriers of latent TB infections. It causes 2 million deaths a year and infects 8 million new cases a year.

The threat of TB outbreaks even in Europe and North America costs countries hundreds of millions of Euros to control every year. Yet the immediate, solvable challenge in TB is simply to diagnose the disease quickly and simply with robust, fully-tested kits. This would then enable treatment prior to the manifestation of the clinical and transmissible aspects.

The majority of TB patients are still diagnosed using the tools of the Victorian era — Tuberculin skin tests, sputum smears and a microscope. But the Tuberculin test is unspecific and the smear microscopy insensitive, and in rural areas in developing countries even a microscope is not always available.

Cheap, simple but more accurate techniques are needed, that can be used in primary healthcare settings in the developing world.

TB diagnostics development needs serious investment, and ‘useless’ tests already on the market need independent testing and effective regulation.

Both are direct challenges to policy makers who tend to neglect research into diagnostics because it is not so attractive as developing new drugs. New drugs and vaccines are also urgently needed, to shorten treatment courses and reduce patient drop-out, but the first priority is better diagnosis.

Further information

1. The report of the workshop can be downloaded as a PDF file from:
www.efb-central.org/images/uploads/Eagles_Health_Report_picture1.pdf

2. For a review of commercial serological antibody detection tests see:
Karen R Steingart, et al. A systematic review of commercial serological antibody detection tests for the diagnosis of pulmonary tuberculosis. PLoS Medicine. 2007.
http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/
journal.pmed.0040202&ct=1

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