New and improved tuberculosis diagnostics: evidence, policy, practice, and impact

Area of Science:

• Public Health
• Infectious Disease Diagnostics
• Health Policy

Background:

• Case detection remains a critical barrier in global tuberculosis (TB) control efforts.
• Significant advancements have occurred in the TB diagnostics pipeline, driven by increased interest and funding.
• Existing evidence primarily consists of test accuracy studies, with notable gaps like the absence of point-of-care tests.

Purpose of the Study:

• To consolidate the evidence supporting tuberculosis diagnostics.
• To examine current policies related to TB diagnostics.
• To explore the translation of evidence into policy, identify evidence limitations, and discuss implementation challenges.

Main Methods:

• Literature review of evidence base for TB diagnostics.
• Analysis of recent policy documents and guidelines for TB diagnostics.
• Discussion of policy translation, evidence gaps, and implementation challenges.

Main Results:

• An expanding pipeline of new TB diagnostics is available.
• Several new policies and guidelines for TB diagnostics have been established.
• Gaps persist in the diagnostics pipeline, particularly for point-of-care solutions, and the evidence base is largely accuracy-focused.

Conclusions:

• Translating new TB diagnostic policies into practice is the critical next step.
• The impact of new tests hinges on their adoption within the global public sector, influenced by international and national TB programs.
• Engaging all stakeholders is essential to convert evidence-based policies into tangible public health and epidemiological impact.