title: Perspectives on Advances in Tuberculosis Diagnostics, Drugs, and Vaccines.
abstract: Despite concerted efforts over the past 2 decades at developing new diagnostics, drugs, and vaccines with expanding pipelines, tuberculosis remains a global emergency. Several novel diagnostic technologies show promise of better point-of-care rapid tests for tuberculosis including nucleic acid-based amplification tests, imaging, and breath analysis of volatile organic compounds. Advances in new and repurposed drugs for use in multidrug-resistant (MDR) or extensively drug-resistant (XDR) tuberculosis have focused on development of several new drug regimens and their evaluation in clinical trials and now influence World Health Organization guidelines. Since the failure of the MVA85A vaccine 2 years ago, there have been no new tuberculosis vaccine candidates entering clinical testing. The current status quo of the lengthy treatment duration and poor treatment outcomes associated with MDR/XDR tuberculosis and with comorbidity of tuberculosis with human immunodeficiency virus and noncommunicable diseases is unacceptable. New innovations and political and funder commitment for early rapid diagnosis, shortening duration of therapy, improving treatment outcomes, and prevention are urgently required.
authors.affiliation: Critical Path to TB Drug Regimens, Critical Path Institute, Tucson, Arizona.
authors.forename: Marco
authors.initials: M
authors.lastname: Schito
authors.affiliation: World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute, Tradate, Italy.
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Migliori
authors.affiliation: Department of Immunology and Infection, London School of Hygiene and Tropical Medicine.
authors.forename: Helen A
authors.initials: HA
authors.lastname: Fletcher
authors.affiliation: TB Alert, Brighton, United Kingdom.
authors.forename: Ruth
authors.initials: R
authors.lastname: McNerney
authors.affiliation: World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute, Tradate, Italy.
authors.forename: Rosella
authors.initials: R
authors.lastname: Centis
authors.affiliation: World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Fondazione S. Maugeri, Care and Research Institute, Tradate, Italy.
authors.forename: Lia
authors.initials: L
authors.lastname: D'Ambrosio
authors.affiliation: University of Zambia-University College London Medical School Research and Training Project, University Teaching Hospital, Lusaka, Zambia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Bates
authors.affiliation: Kilimanjaro Clinical Research Institute, Moshi, Tanzania.
authors.forename: Gibson
authors.initials: G
authors.lastname: Kibiki
authors.affiliation: University of Zambia-University College London Medical School Research and Training Project, University Teaching Hospital, Lusaka, Zambia.
authors.forename: Nathan
authors.initials: N
authors.lastname: Kapata
authors.affiliation: Department of Infectious Diseases and Tropical Medicine, Northwick Park Hospital.
authors.forename: Tumena
authors.initials: T
authors.lastname: Corrah
authors.affiliation: Department of Nuclear Imaging, University College London Hospitals NHS Foundation Trust, United Kingdom.
authors.forename: Jamshed
authors.initials: J
authors.lastname: Bomanji
authors.affiliation: Unitat de Tuberculosi Experimental, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Ctra. de Can Ruti, Camí de les Escoles, Barcelona, Spain.
authors.forename: Cris
authors.initials: C
authors.lastname: Vilaplana
authors.affiliation: Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Johnson
authors.affiliation: University of Zambia-University College London Medical School Research and Training Project, University Teaching Hospital, Lusaka, Zambia.
authors.forename: Peter
authors.initials: P
authors.lastname: Mwaba
authors.affiliation: Therapeutic Immunology, Departments of Laboratory Medicine and Microbiology, Tumour and Cell Biology, Karolinska Institute, Stockholm, Sweden.
authors.forename: Markus
authors.initials: M
authors.lastname: Maeurer
authors.affiliation: Division of Infection and Immunity, University College London and National Institute for Health Research Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, United Kingdom.
authors.forename: Alimuddin
authors.initials: A
authors.lastname: Zumla
mesh_terms: D000995:Antitubercular Agents / Q000737:chemistry / Q000145:classification / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D054908:Extensively Drug-Resistant Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D015658:HIV Infections / Q000150:complications; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000235:genetics; D019095:Point-of-Care Systems / Q000191:economics; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D032581:Tuberculosis Vaccines; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D019444:Vaccines, DNA; D014944:World Health Organization
chemical_list: D000995:Antitubercular Agents; C549320:MVA 85A; D032581:Tuberculosis Vaccines; D019444:Vaccines, DNA
keywords: diagnostics; drugs; management; tuberculosis; vaccines