Tuberculosis diagnostics and biomarkers: Needs, challenges, recent advances, and opportunities

Ruth McNerney, Markus Maeurer, Ibrahim Abubakar, Ben Marais, Timothy D. McHugh, Nathan Ford, Karin Weyer, Steve Lawn, Martin P. Grobusch, Ziad Memish, S. Bertel Squire, Giuseppe Pantaleo, Jeremiah Chakaya, Martina Casenghi, Giovanni Batista Migliori, Peter Mwaba, Lynn Zijenah, Michael Hoelscher, Helen Cox, Soumya SwaminathanPeter S. Kim, Marco Schito, Alexandre Harari, Matthew Bates, Samana Schwank, Justin O'Grady, Michel Pletschette, Lucica Ditui, Rifat Atun, Alimuddin Zumla*

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    141 Citations (Scopus)


    Tuberculosis is unique among the major infectious diseases in that it lacks accurate rapid point-of-care diagnostic tests. Failure to control the spread of tuberculosis is largely due to our inability to detect and treat all infectious cases of pulmonary tuberculosis in a timely fashion, allowing continued Mycobacterium tuberculosis transmission within communities. Currently recommended gold-standard diagnostic tests for tuberculosis are laboratory based, and multiple investigations may be necessary over a period of weeks or months before a diagnosis is made. Several new diagnostic tests have recently become available for detecting active tuberculosis disease, screening for latent M. tuberculosis infection, and identifying drug-resistant strains of M. tuberculosis. However, progress toward a robust point-of-care test has been limited, and novel biomarker discovery remains challenging. In the absence of effective prevention strategies, high rates of early case detection and subsequent cure are required for global tuberculosis control. Early case detection is dependent on test accuracy, accessibility, cost, and complexity, but also depends on the political will and funder investment to deliver optimal, sustainable care to those worst affected by the tuberculosis and human immunodeficiency virus epidemics. This review highlights unanswered questions, challenges, recent advances, unresolved operational and technical issues, needs, and opportunities related to tuberculosis diagnostics.

    Original languageEnglish
    Pages (from-to)S147-S158
    JournalJournal of Infectious Diseases
    Issue numberSUPPL. 2
    Publication statusPublished - 15 May 2012

    Bibliographical note

    Funding Information:
    Financial support. This work was supported by EuropeAID, Belgium; European and Developing Countries Clinical Trials Partnership (EDCTP), Netherlands; UK Medical Research Council (MRC); and UBS Optimus Foundation, Switzerland. A. Z. is supported by the University College London Hospitals Comprehensive Biomedical Research Centre (UCLH-CBRC) and the UCL Hospitals National Health Service (NHS) Foundation Trust. Potential conflicts of interest. All authors: No reported conflicts.


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