Improved access to molecular diagnostic technologies plays an important role in controlling the MDR-TB epidemic, but LMICs are essentially currently limited to the use of Xpert and Ultra, with centralized culture DST, LPAs, and rarely WGS. Until an accurate molecular diagnostic for full rapid DST is developed for use at the peripheral level, national TB programs should optimize the use of currently available MDRTB tests. But the epidemic will ultimately only be favorably impacted by complete end-to-end solutions to patients that address the complete cascade of care, including patient-centered diagnosis and treatment of TB and MDR-TB, management of comorbidities and social protection.
PDF attached.
Talbot Pai IJTLD 2019.pdf (241.0 KB)