Review article: Tuberculosis diagnosis: From knowledge to innovation in public health

• Main Author: Chayada Sitthidet Tharinjaroen
• Format: Article
• Language: English
• Published: Chaing Mai University 2017-01-01
• Series: Journal of Associated Medical Sciences
• Subjects: Mycobacterium tuberculosis complex; tuberculosis; tuberculosis diagnostic
• Online Access: https://www.tci-thaijo.org/index.php/bulletinAMS/article/view/74776

Tuberculosis (TB) is a serious global infectious disease caused by inhalation of droplets containing bacterial cells classified as Mycobacterium tuberculosis complex (MTBC). Among MTBC, M. tuberculosis has been known as the main causal agent of TB. MTBC infection usually exhibits pulmonary tuberculosis, but extrapulmonary tuberculosis can also be detected among TB cases. Acid fast stain, culture method and biochemical tests are standard protocols. However, MTBC is a slow growing organism and sometime generates controversial results of the biochemical tests. These result in inaccurate and delayed diagnosis and treatment that lead to inefficient control of TB. Thus, rapid and accurate TB diagnosis method and drug susceptibility test are essential. Previously, alternative techniques were newly developed, for example, fluorescence stain with increased sensitivity for directly detection MTBC in sputum specimen. The automated liquid culture system with reduced culture time among TB-positive samples. In addition, in order to increase sensitivity and specificity while reducing time of diagnosis, several molecular techniques were developed such as GeneXpert MTB/RIF, Line probe and Urinary LAM. Recently, a novel diagnostic kit so called “IMS-PCR-CTPP” was developed based on the improvement of Mycobacterium binding in direct specimen using monoclonal antibody coated immunomagnatic beads prior to bacterial identification using PCR-CTPP targetting the novel target gene, lepB. Unlike previously reported techniques, it offers simultaneous determination of MTBC and Mycobacterium bovis infection. Obviously, there are various methods currently available for diagnosis of TB, however, they possess distinct advantages and limitations. Therefore, applying the combination of standard and new techniques will significantly improve accuracy and reduce time of TB diagnosis, which is crucial for effective treatment and control of TB. Journal of Associated Medical Sciences 2017; 50(1): 1-21. Doi: 10.14456/jams.2017.1