The World Health Organization (WHO) is urging countries to expand access to rapid molecular tests to detect TB and drug-resistant TB in consolidated guidelines released today. There are guidelines for national TB programs, ministries of health and technical partners, along with an operational manual to facilitate rapid implementation and rapid molecular trials.
"It is recommended to use rapid molecular assays as initial tests for diagnosis of TB rather than spit smear microscopy because they have high diagnostic accuracy and are large in the early detection of TB and drug-resistant TB. Will lead the reform, ”Dr. Said Teza Kaseva, director of WHO's Global TB Program. “We now need to ensure universal access to these rapid molecular tests. This will have a positive effect on reducing transmission and enabling faster access to accurate life-saving treatment that will lead to better outcomes for those affected. "
The consolidated guidelines and associated operational manual recommend major updates to the approach to the diagnosis of TB:
- use of Xpert MTB / RIF Assay, Xpert Ultra Assay and Trinetra Assay In form of Preliminary tests to diagnose pulmonary TB and detect rifampicin resistance. This smear replaces microscopy and culture.
- use of Xpert MTB / RIF Assay and Xpert Ultra Assay For better diagnosis of TB and rifampicin resistance children, In specific specimens such as sputum, feces, nasopharyngeal and gastric specimens
- use of Xpert MTB / RIF Assay and Xpert Ultra Assay For better diagnosis of TB and rifampicin resistance in a wide range of patients Additional TB.
The Xpert MTB Rif assay has been used worldwide since 2010, while the Xpert Ultra assay and the Truenat assay are new techniques.
The above guidelines were indicated in January 2020 via Rapid Communication from WHO prior to publication of the updated guidelines. The aim was to help national TB programs and other stakeholders plan and prepare in advance for the rapid transition to new diagnostic tools at the country level.
Globally, the diagnosis of TB and drug-resistant TB is a challenge with one-third of people with TB and two-thirds of those with drug-resistant TB remaining undetected. Rapid efforts to diagnose TB and drug-resistance are necessary to end the global TB pandemic and to achieve the goals of the Political Declaration of the United Nations High Level Meeting, WHO & TB Strategy, UN Sustainable Development Goals, Universal Health Triple Arab goals of coverage and general program of work of WHO.