CONCLUSION
Xpert is the most exciting innovation in TB diagnostics in over a century. It has the potential to significantly increase TB case detection in 2 priority populations in which traditional diagnostics are woefully inadequate—people with suspected HIV-associated TB and MDR-TB. The possibility to diagnose TB in these important groups in 2 hours will lead to fewer deaths and less transmission of disease.
However, Xpert is not a panacea. Its implementation presents major challenges, particularly related to cost and infrastructure, which call for a thoughtfully phased and careful introduction. Strong health systems are required in order to realize the full potential of this new technology. Also,Xpert is not a point-of-care test, which remains an important need in TB diagnostics. Fast and accurate detection of TB and MDR-TB needs to happen at the community level with a point-of-care test and a strong laboratory network and referral system to ensure that patients have access to all the diagnostic and follow-up testing they need.
Nevertheless, Xpert is more than just a “test”—it is transforming the way we think about diagnosing TB. Countries have to make decisions about where to place the test; clinicians have to learn to trust the test results; program managers must embrace the challenges of implementing a new technology; and policy makers must agree to invest with adequate funding for scale up.
CONCLUSION
Xpert is the most exciting innovation in TB diagnostics in over a century. It has the potential to significantly increase TB case detection in 2 priority populations in which traditional diagnostics are woefully inadequate—people with suspected HIV-associated TB and MDR-TB. The possibility to diagnose TB in these important groups in 2 hours will lead to fewer deaths and less transmission of disease.
However, Xpert is not a panacea. Its implementation presents major challenges, particularly related to cost and infrastructure, which call for a thoughtfully phased and careful introduction. Strong health systems are required in order to realize the full potential of this new technology. Also,Xpert is not a point-of-care test, which remains an important need in TB diagnostics. Fast and accurate detection of TB and MDR-TB needs to happen at the community level with a point-of-care test and a strong laboratory network and referral system to ensure that patients have access to all the diagnostic and follow-up testing they need.
Nevertheless, Xpert is more than just a “test”—it is transforming the way we think about diagnosing TB. Countries have to make decisions about where to place the test; clinicians have to learn to trust the test results; program managers must embrace the challenges of implementing a new technology; and policy makers must agree to invest with adequate funding for scale up.
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