Article

Mycobacterium tuberculosis (MTB)

Tuberculosis remains a global challenge

As the world’s deadliest infectious disease, tuberculosis (TB) is estimated to infect 10 million people and accounted for >1.5 million deaths in 2021.1 Caused by the bacillus Mycobacterium tuberculosis (MTB), TB co-infection with HIV and other pathogens further complicate diagnostic and treatment strategies for patients. While TB is preventable and curable, underreporting of people diagnosed and underdiagnosis remains a major challenge to the eradication of TB.

Diagnosis challenge

Of the TB deaths,  an estimated 214,000 cases were among patients co-infected with HIV.1 In some African regions, the co-infection rate exceeds 50%. 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.

31% of hiv deaths occurred in patients with TB
31% of HIV deaths

Occurred in patients with a TB co-infection

A major challenge to the eradication of TB is locating and providing quality diagnostics to patients with suspected infection.

In 2021, only 33% of notified cases received a molecular test despite this global recommendation from the World Health Organization (WHO). This translates to only 2 million TB patients receiving a molecular test of the 6 million notified cases per year. Presumably, the 4 million cases that are not notified (often referred to as the "missing millions") to TB programmes also do not receive a molecular test.

Patients will benefit globally through the adoption and implementation of WHO TB diagnostic guidelines.

illustration to show 30% of TB cases are never diagnosed
Missing cases

Approximately 40% of new cases are either not diagnosed or not reported to national TB programmes

While TB infects humans globally, the disease is prevalent in 30 high TB-burden countries and account for 90% of the TB infections worldwide. The solution is comprehensive diagnostic tools that detect TB and resistance markers rapidly and accurately to help ensure patients get the care they need.

Anti-microbial resistance

Anti-microbial resistance (AMR) continues to be a growing problem in treating infectious diseases. To combat this health threat, every TB patient confirmed should receive a first-line drug resistance test. The ability to initiate proper treatment from the start is important for both patient health and the eradication of TB.

The WHO’s strategy to end TB

Strategies to address the global health challenge of TB are outlined and endorsed by both the United Nations and the World Health Organization. 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.

end-tb-strategy-graph
Nontuberculous mycobacteria

Similar to TB, nontuberculous mycobacteria (NTM) infections are a rising health challenge in certain populations. Although NTM's can be found on body surfaces and in secretions without directly causing disease, they have been associated with four distinct clinical syndromes. These include progressive pulmonary disease, disseminated disease in severely immunocompromised patients, and skin and soft tissue (including lymphatic) infections usually as a consequence of direct inoculation.2

4 distinct clinical syndromes
  • Progressive pulmonary disease
  • Disseminated disease
  • Cutaneous
  • Lymphatic disease
Molecular diagnostic algorithm

A complete mycobacteria menu provides the flexibility to detect a combination of TB, drug-resistant TB and NTM infections from a single patient sample. This provides complete information for patient care decisions.

MTB Diagnostic Algorithm

References

  1. Global tuberculosis report 2021. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.
  2. Tortoli E. Clin Microbiol Infect. 2009 Oct;15(10):906-10.