WHO calls on countries to expand access to rapid molecular tests to detect TB and XDR-TB

WHO calls on countries to expand access to rapid molecular tests to detect TB and LU-TB

June 30, 2020 | GENEVA - The World Health Organization (WHO) is calling on countries to expand access to rapid molecular tests to detect tuberculosis and drug-resistant tuberculosis in updated consolidated guidelines released today. The manual is accompanied by an operational handbook to facilitate the rapid implementation and deployment of rapid molecular tests by national tuberculosis programs, ministries of health and technical partners.

"It is recommended to use rapid molecular assays as an initial test for the diagnosis of tuberculosis instead of sputum smear microscopy, as they have high diagnostic accuracy and will lead to significant improvements in the early detection of tuberculosis and drug-resistant tuberculosis," said Dr. Teresa Kasaeva, Director of the WHO Global Tuberculosis Program. "We now urgently need to ensure universal access to these rapid molecular tests. This will have a positive impact on reducing transmission and providing faster access to accurate life-saving treatment that will lead to better outcomes for those affected."

The consolidated guidelines and the corresponding operational handbook recommend key updates to approaches to the diagnosis of tuberculosis, including:

The use of Xpert MTB/RIF analysis, Xpert Ultra analysis and Truenat analysis as an initial test for the diagnosis of pulmonary tuberculosis and the detection of resistance to rifampicin. This replaces smear microscopy and culture.

The use of the Xpert MTB/RIF test and the Xpert Ultra test to improve the diagnosis of tuberculosis and resistance to rifampicin in children in specific samples, such as sputum, feces, nasopharynx and stomach samples

The use of the Xpert MTB / RIF test and the Xpert Ultra test to improve the diagnosis of tuberculosis and resistance to rifampicin in patients with a wide range of extrapulmonary tuberculosis.

Xpert MTB Rif analysis has been used worldwide since 2010, while Xpert Ultra analysis and Truenat analysis are new technologies.

The above-mentioned updates were reported in January 2020 through a quick communication with WHO before the publication of the updated guidelines. The aim was to help national TB programmes and other stakeholders plan and prepare in advance for the rapid transition to new diagnostic tools at the country level.

Worldwide, the diagnosis of tuberculosis and drug-resistant TB remains a difficult task, with one third of people with TB and two thirds of people with drug-resistant TB not being detected. Accelerated efforts to diagnose tuberculosis and drug resistance are needed to end the global tuberculosis epidemic and achieve the goals of the UN High-level Political Declaration, the WHO tuberculosis strategy, the UN Sustainable Development Goals, universal health coverage and the three billion goals of the WHO general work programme.

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