Contemporary Microbiological Diagnostic Tests for Rapid Identification and Detection of Resistance of Mycobacterium tuberculosis
Tuberculosis (TB) occurs in every part of the world as a top infectious disease killer. In 2014, 9.6 million cases and 1.5 million deaths (140 000 children) from TB were registered. Over 95% of TB deaths occur in developing countries.
The Millennium Development Goal target of halting and reversing the TB epidemic by 2015 has been met globally. TB incidence has fallen since 2000 and is now 18% lower, by an average of 1.5% per year. An estimated 43 million lives were saved through TB diagnosis and treatment between 2000 and 2014. Another Goal target is ending the TB epidemic by 2030.
According WHO Director General, „Everyone with TB should have access to the innovative tools and services they need for rapid diagnosis, treatment and care. This is a matter of social justice, fundamental to our goal of universal health coverage”.
In cases of drug-susceptibility, TB is a treatable and curable disease with a standard 6 month protocol of 4 antimicrobial drugs. In some cases, extensively drug-resistant TB, XDR-TB, a form of multi-drug resistant TB with weak responds including the most effective second-line anti-TB drugs. About 480 000 people developed MDR-TB in the world in 2014.
Establishing, equipping, financing, and ensuring sustainability of appropriate laboratory networks are challenging, complex and expensive, but necessary for an effective response to the challenges of TB-HIV and drug-resistant TB (DR-TB) control.
Beside classical methods for isolation, identification and susceptibility testing, Reference laboratories introduce new, rapid methods.
New systems for isolation use selective, liquid media (BACTEC, MGIT), which enable final diagnosis in about two weeks.
In 2012, for the first time, rapid diagnostic test GeneExpert (based on molecular technics was established in Republic of Macedonia. GeneXpert MTB/RIF is an automated, cartridge-based nucleic amplification assay for the simultaneous detection of TB and rifampicin resistance directly from sputum in under two hours.
As a result of use of contemporary standards for detection, treatment and prevention of TB included in National program for control of TB, in connection with realization of the Program for control of TB financially supported with grant of Global fund to fight against HIV/AIDS, TB and malaria, from 2002 to date number of new cases with TB in Rebublic of Macedonia significantly decreased.