title: Tuberculosis diagnostics and biomarkers: needs, challenges, recent advances, and opportunities.
abstract: Tuberculosis is unique among the major infectious diseases in that it lacks accurate rapid point-of-care diagnostic tests. Failure to control the spread of tuberculosis is largely due to our inability to detect and treat all infectious cases of pulmonary tuberculosis in a timely fashion, allowing continued Mycobacterium tuberculosis transmission within communities. Currently recommended gold-standard diagnostic tests for tuberculosis are laboratory based, and multiple investigations may be necessary over a period of weeks or months before a diagnosis is made. Several new diagnostic tests have recently become available for detecting active tuberculosis disease, screening for latent M. tuberculosis infection, and identifying drug-resistant strains of M. tuberculosis. However, progress toward a robust point-of-care test has been limited, and novel biomarker discovery remains challenging. In the absence of effective prevention strategies, high rates of early case detection and subsequent cure are required for global tuberculosis control. Early case detection is dependent on test accuracy, accessibility, cost, and complexity, but also depends on the political will and funder investment to deliver optimal, sustainable care to those worst affected by the tuberculosis and human immunodeficiency virus epidemics. This review highlights unanswered questions, challenges, recent advances, unresolved operational and technical issues, needs, and opportunities related to tuberculosis diagnostics.
authors.affiliation: Department of Pathogen Molecular Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom.
authors.forename: Ruth
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authors.lastname: McNerney
authors.forename: Markus
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authors.lastname: Maeurer
authors.forename: Ibrahim
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authors.lastname: Abubakar
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authors.initials: TD
authors.lastname: McHugh
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authors.lastname: Weyer
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authors.lastname: Grobusch
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authors.forename: S Bertel
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authors.lastname: Squire
authors.forename: Giuseppe
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authors.lastname: Pantaleo
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Chakaya
authors.forename: Martina
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authors.lastname: Casenghi
authors.forename: Giovanni-Batista
authors.initials: GB
authors.lastname: Migliori
authors.forename: Peter
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authors.lastname: Mwaba
authors.forename: Lynn
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authors.lastname: Zijenah
authors.forename: Michael
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authors.lastname: Hoelscher
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authors.lastname: Cox
authors.forename: Soumya
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authors.lastname: Swaminathan
authors.forename: Peter S
authors.initials: PS
authors.lastname: Kim
authors.forename: Marco
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authors.lastname: Schito
authors.forename: Alexandre
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authors.lastname: Harari
authors.forename: Matthew
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authors.lastname: Bates
authors.forename: Samana
authors.initials: S
authors.lastname: Schwank
authors.forename: Justin
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authors.lastname: O'Grady
authors.forename: Michel
authors.initials: M
authors.lastname: Pletschette
authors.forename: Lucica
authors.initials: L
authors.lastname: Ditui
authors.forename: Rifat
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authors.lastname: Atun
authors.forename: Alimuddin
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authors.lastname: Zumla
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology / Q000627:therapeutic use; D001431:Bacteriological Techniques / Q000379:methods; D015415:Biomarkers; D024881:Drug Resistance, Bacterial; D006801:Humans; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents; D015415:Biomarkers