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Development, testing and introduction of new diagnostic tools for tuberculosis

Published on April 2, 2014   35 min

A selection of talks on Clinical Practice

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0:00
Good day. This is Mark Perkins. I am the Chief Scientific Officer of FIND, the Foundation for Innovative New Diagnostics here in Geneva, Switzerland. Today we're going to be talking about the development, testing, and introduction of a new diagnostic tools for tuberculosis, an area in which there has been considerable change in the last few years.
0:18
Over the past two decades there have been remarkable improvements and changes in biotechnology, specifically in diagnostic testing; everything from whole genome bacterial sequencing to handheld quantitative assays. However, none of these changes have led to diagnostic solutions for communicable diseases for people living in impoverished conditions. Diseases linked to poverty are still, basically, insufficiently equipped, in too many settings.
0:45
A good example of this is tuberculosis, a disease, which for many years has relied on the same fundamental diagnostic test - the microscope. Here is a picture of, in fact, the microscope of Robert Koch. And that microscope he used in 1882 to define TB in the first place would look very much at home in a modern laboratory in many countries in the world.
1:08
This view through a microscope looking at a Ziehl-Neelsen stain preparation is similar to what Koch may have seen more than 100 years ago. The trouble with microscopy not only is it relatively awkward, burdensome to do and requires a substantial training, but it gives no information about drug susceptibility results or about the species of the bacteria you see.
1:30
The result of this relative poverty of the diagnostic test is long delays in the process of diagnosis itself. Here's a picture at a routine clinic, a diagnostic clinic, in India where patients would see to wait for the diagnosis of the cause of their prolonged cough. True diagnostic delays often runs to the three to nine months period, resulting, of course, in the ongoing transmission, ongoing disease accrual. What you see the top of the slide are numbers from the global epidemiology of tuberculosis showing in blue the relatively large number of detected and notified smear positives-- 1.9 million-- and smear negative cases-- 2.2 million-- and even larger number of undetected or unreported cases that don't get to the WHO. Some of those are detected and non-reported. Some are non-detected. And this adds to the large number of TB mortality cases. On the right, is the amount of spending that we see not only by patients and direct costs, but by governments and loss of revenue from tuberculosis and, specifically, from the delayed diagnosis.
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Development, testing and introduction of new diagnostic tools for tuberculosis

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