Mycobacterium tuberculosis (MTB, TB) remains a global challenge.
In 2018, it is estimated that 10.0 million people had tuberculosis and 1.5 million died. Approximately 30% of new infections were undiagnosed, or detected but not reported, and drug resistance is on the rise. Co-infection with HIV and other pathogens further complicate the patients diagnostic and care cascades. Despite these numbers, tuberculosis is curable.
Globally, one-third of HIV deaths were co-infected with tuberculosis, complicating both the diagnosis and treatment. In some geographies, the co-infection rate nears 70%. Multi-disease testing systems are poised to streamline the way diseases are diagnosed, providing a more complete picture for the physician to initiate proper treatment.
A major challenge to the eradication of tuberculosis is locating and providing quality diagnostics to patients with suspected tuberculosis. In 2018, 30% of tuberculosis cases went undiagnosed, or diagnosed but not reported, according to the World Health Organization (WHO). This represented 3.0 million instances that went undiagnosed and untreated, potentially allowing further transmission. To meet the End TB Strategy targets, the efficient scaling of diagnostic capacity is required.
While tuberculosis infects humans globally, the burden of disease has geographic patterns and the challenge is multifaceted. Comprehensive diagnostics is part of the solution. Diagnosing tuberculosis and resistance markers rapidly, accurately and with great sensitivity is critical to initiate proper treatment.
Anti-microbial resistance (AMR) continues to be a growing threat to global health. Tuberculosis is estimated to account for one-third of deaths due to AMR. To combat this health threat, every tuberculosis patient confirmed to be positive should receive a first-line drug resistance test at a minimum. The ability to initiate proper treatment from the start is important for both patient health and the eradication of tuberculosis.
World Health Organization: end TB strategy
Strategies to address the global health challenge of TB are outlined and endorsed by both the United Nations and World Health Organization (WHO). Complementary milestones aim to reduce TB deaths by 95%, cut new cases by 90% and ensure no family is burdened with catastrophic costs related to TB. These are important metrics that can only be met through a diverse approach to diagnostics.
Similar to tuberculosis, nontuberculous mycobacteria (NTM) infections are a rising health challenge in certain populations. Althought NTM's can be found on body surfaces and in secretions without causing disease, they have been associated with four distinct clinical syndromes; progressive pulmonary disease, disseminated disease in severely immunocompromised patients, and skin and soft tissue (including lymphatic) infections usually as a consequence of direct inoculation.
Molecular diagnostic algorithm
A complete mycobacteria menu provides the flexibility to detect a combination of tuberculosis, drug resistant tuberculosis and nontuberculous mycobacteria infections from a single patient sample. This provides complete information for patient care decisions.