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WHO urges countries to expand access to rapid molecular tests to detect TB and drug-resistant TB
The World Health Organization (WHO) is urging countries to expand access to rapid molecular tests to detect drug-resistant TB and TB in updated consolidated guidelines. The guidelines are accompanied by an operational manual that facilitates the rapid implementation and conduct of rapid molecular tests by national tuberculosis programs, ministries of health and technical partners.
“The use of rapid molecular tests as an initial test to diagnose TB is recommended instead of a microscopic smear of smeared saliva because they have high diagnostic accuracy and will lead to major improvements in early detection of TB and drug-resistant TB,” she said. Dr. Tereza Kasaeva, Director of the WHO World Tuberculosis Program. “We must now urgently ensure universal access to these rapid molecular tests. This will have a positive effect on reducing transmission and allowing faster access to life-saving precision treatment that will lead to better outcomes for sufferers. “
The Consolidated Guidelines and the accompanying Operations Manual recommend key developments in the approach to diagnosing TB, including:
- Use Xpert MTB / RIF test, Xpert Ultra test i Truenat test as initial test to diagnose pulmonary TB and detect rifampicin resistance. This replaces microscopy and smear culture.
- Use Xpert MTB / RIF test and Xpert Ultra test for improved diagnosis of TB and rifampicin resistance in children, in specific samples such as sputum, stool, nasopharynx and stomach samples
- Use Xpert MTB / RIF test and Xpert Ultra test for improved diagnosis of TB and rifampicin resistance in a wide range of patients extrapulmonary TB.
The Xpert MTB Rif test has been used worldwide since 2010, while the Xpert Ultra and Truenat test are new technologies.
The above updates were signaled in January 2020 via WHO rapid communication prior to the publication of the updated guidelines. The aim was to help national tuberculosis programs and other stakeholders plan and prepare in advance for a rapid transition to new diagnostic tools at the state level.
Globally, diagnosing TB and drug-resistant TB remains a challenge, with one-third of TB patients and two-thirds of people with drug-resistant TB not being detected. Accelerated efforts to diagnose TB and drug resistance are key to halting the global TB epidemic and achieving the goals of the UN High Level Political Declaration, the TB end-of-TB strategy, the UN this sustainable development, universal health insurance and the triple billion goals of the General Work Program of the World Health Organization.
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