Diagnostic tools in tuberculosis. Present and future

Leadership will play a major role in the management of tuberculosis in the future. Many populations, such as immunocompromised patients and immigrants from countries with a higher prevalence of tuberculosis, create a challenge for care and diagnosis. Mycobacterial laboratory testing has undergone many changes in the past 10 years with the advent of nucleic acid probes for identification of Mycobacterium tuberculosis, and more recently nucleic acid amplification and beyond where computer technology meets molecular biology. In the past, changes for tuberculosis testing were not incorporated rapidly, sometimes taking 20 years or more to be fully implemented. The dynamics of acceptance of change and more rapid implementation need to be understood. With the use of such programs as Fast Track for Tuberculosis Testing, this can be accomplished more readily. New technologies can be provided to all users of such a network within a short amount of time and health care providers can equally benefit from this novel approach. The tuberculosis laboratory cannot stand alone. It must work together with other players, in order to eliminate tuberculosis.