alexa Point-of-Care Diagnostics for Tuberculosis: Are we there? | Open Access Journals
ISSN: 2161-1068
Mycobacterial Diseases
Like us on:
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Point-of-Care Diagnostics for Tuberculosis: Are we there?

Amani Mansour Mohmad Alnimr*

College of Medicine, University of Dammam, Saudi Arabia

Corresponding Author:
Amani Mansour Mohmad Alnimr
Assistant Professor & Consultant Clinical Microbiologist
King Fahad Hospital of the University College of Medicine
University of Dammam, Saudi Arabia
Tel: +9668966666
E-mail: [email protected]

Received Date: December 03, 2013; Accepted Date: December 04, 2013; Published Date: December 16, 2013

Citation: Alnimr AMM (2013) Point-of-Care Diagnostics for Tuberculosis: Are we there? J Mycobac Dis 4:e124. doi:10.4172/2161-1068.1000e124

Copyright: © 2013 Alnimr AMM. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Mycobacterial Diseases

Keywords

Specimens; Drug-resistant; Microscopy; HIV

Introduction

With the increasing incidence of tuberculosis including its drugresistant forms, point-of-care-diagnostics for tuberculosis (POCTTB) are desirable. Smear-microscopy was the first point-of-care test for tuberculosis. It can be performed on un-centrifuged specimens at the point of care. The introduction of the low cost light-emitting diode (LED) microscopy with the benefit of fluorescence microscopy without the associated operational requirements, has offered a new tool for POCT-TB [1]. More recently, the processing of serial sputum specimen examinations in the front-loaded microscopy approach focuses on collecting several specimens during one visit [2]. Although this may lead to a reduced diagnostic sensitivity for the individual patient but is expected to improve rate of active case finding by reducing dropout rates [3,4].

Nucleic acid amplification tests (NAATs) offered a new platform for POCT-TB. Although the Xpert MTB/RIF assay was not evaluated specifically as a POCT-TB in primary care settings, its suitability for point of care use is suggested by its fully automated nature and totally closed environment to detects M. tuberculosis complex and identify Multi-drug resistant (MDR) form. Another advantage of performing Xpert MTB/RIF as a POCT-TB is to be able to identify highly infectious patients since the cycle threshold (Ct) values generated correlate with the bacillary load [5,6]. The available evidence shows that crosscontamination and error rates are minimal, and the assay performance was shown to be equivalent when performed at primary care versus reference laboratories [5]. There is a growing body of evidence that up to 8 log reduction in colony forming units occurs in the clinical samples following their treatment with the buffer provided with the system [7,8]. Thus the cartridge waste generated by the procedure may not represent a great hazard. Of note aerosolized viable bacilli are not encountered unless the specimens were incorrectly processed [8] which were still less than those generated by microscopy, thus Xpert MTB/ RIF is likely to provide a safer procedure than smear microscopy in the absence of a biosafety cabinet. An area of concern is the higher cost of Xpert MTB/RIF compared to smear microscopy although a study by Vassal et al showed its cost-effectiveness [9]. One approach suggested to reduce cost is to perform the assay only in smear-negative cases in high prevalence countries. This may not be the optimum in low-intermediate prevalence settings or in patients with risk factors for infections by non-tuberculous mycobacterial. Another concern is to provide an effective algorithm to deal with cases that are detected as MDR tuberculosis by Xpert MTB/RIF at the point of care. Other novel approaches for POCT-TB include antigen- and serology-based assays but these are still investigational. Of clinical interest also is monitoring treatment compliance, which is another, evolving area of POCT-TB [10].

A future point-of-care-diagnostic needs to have a reliable performance, ability to test different types of clinical specimens in different patient populations including HIV cases, and be cost-effective and user friendly. Besides, ability to fit the primary care infrastructure with minimal safety impact is a major requirement for a future POCT TB. Nevertheless, training, competency assessment and proficiency testing will be a cornerstone for the performance of such assays. The launching of POCT-TB will provide a flexible alternative to the current complex diagnostics, which aids in the global control of TB. Research that compares the performance of the candidate assays in the primary care versus the reference laboratories is highly desirable.

References

Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Relevant Topics

Recommended Conferences

Article Usage

  • Total views: 11947
  • [From(publication date):
    February-2014 - Nov 19, 2017]
  • Breakdown by view type
  • HTML page views : 8135
  • PDF downloads : 3812
 

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

 
© 2008- 2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords