Autor/a:
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García-Basteiro, Alberto L.; DiNardo, A.; Saavedra, Belén; Silva, D.R.; Palmero, D.; Gegia, M.; Migliori, Giovanni Battista; Duarte, R.; Mambuque, Edson; Centis, R.; Cuevas, Luis E.; Izco, S.; Theron, Grant
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Abstract:
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The goals of the End TB strategy, which aims to achieve a 90%
reduction in tuberculosis (TB) incidence and a 95% reduction in
TB mortality by 2035, will not be achieved without new tools to
fight TB. These include improved point of care (POC) diagnostic
tests that are meant to be delivered at the most decentralised
levels of care where the patients make the initial contact with
the health system, as well as within the community. These tests
should be able to be performed on an easily accessible sample
and provide results in a timely manner, allowing a quick
treatment turnaround time of a few minutes or hours (in a single
clinical encounter), hence avoiding patient loss-to-follow-up.
There have been exciting developments in recent years, including
the WHO endorsement of Xpert MTB/RIF, Xpert MTB/RIF Ultra,
loop-mediated isothermal amplification (TB-LAMP) and lateral
flow lipoarabinomannan (LAM). However, these tests have
limitations that must be overcome before they can be optimally
applied at the POC. Furthermore, worrying short- to medium-term
gaps exist in the POC diagnostic test development pipeline.
Thus, not only is better implementation of existing tools and
algorithms needed, but new research is required to develop new
POC tests that allow the TB community to truly make an impact
and find the "missed TB cases". |