[Diagnosis of tuberculosis in developing countries: new perspectives]

Area of Science:

• Public Health
• Infectious Diseases
• Medical Diagnostics

Context:

• Tuberculosis (TB) remains a significant global health issue, with current diagnostic methods often lacking sensitivity, particularly in HIV-positive patients.
• The Directly Observed Treatment, Short-course (DOTS) strategy has not fully achieved its ambitious case detection and treatment goals.
• There is an urgent need for improved diagnostic tools to combat the global TB epidemic, as highlighted by the WHO's Global plan to stop TB.

Purpose:

• To review and highlight promising new diagnostic tools for tuberculosis (TB).
• To emphasize the need for sensitive and reliable diagnostic methods, especially for vulnerable populations like HIV-positive individuals.
• To underscore the importance of field trials in high-incidence, low-income countries for validating new diagnostic technologies.

Summary:

• Current TB diagnostic methods are insufficient, necessitating the development of novel approaches.
• Promising innovations include optimized direct microscopic examination with fluorescence microscopes and immunoenzymatic testing on urine samples.
• Further research and clinical trials under real-world conditions are crucial for validating these new diagnostic tools.

Impact:

• Accelerated development and deployment of more sensitive TB diagnostic tools.
• Improved TB case detection rates, particularly in resource-limited settings and among co-infected populations.
• Enhanced global efforts to control and eventually eliminate tuberculosis as a public health threat.