Update on the diagnosis of tuberculosis- Time for a Game Change

Abstract

Tuberculosis,particularlydrug resistant tuberculosis (DR-TB), is a main problem globally especially in developing countries like Pakistan. Drug resistance in tuberculosis is basically a man-made phenomenon caused by inaccurate prescribing practices by physicians and disobedience on the part of patients. Timely diagnose and successful treatment of tuberculosis is a lifesaving intervention. Multidrug resistant tuberculosis (MDR-TB) has become an epidemiological issue and is the most important concern globally. Case management needs to be simplified and standardized as in many countries MDR-TB cases cannot receive individualized care from physicians. Tuberculosis tests are old fashioned and inadequate as the most widely test used is microscopy which misses half of all cases. Recent progress in molecular biology has brought major improvements in diagnosisof tuberculosis with introduction of some new diagnostic techniques. The new automated culture techniques have considerably reduced the time required for detection and antimicrobial susceptibility testing of tuberculosis. Introduction of new technique such as Xpert MTB/RIF test, a game changer, have also shown a lot of promise. However, most of these new techniques are too costly and sophisticated to be of any practical advantage to the common patients of TB living in developing countries for whom a timely and economical diagnosis as restrained as ever. In the present article we studied various existing modalities as well as the new advances in TB/MDR-TB diagnosis