From the coalface

Sponsored by the the National Institutes of Health and published in the latest CID Journal is an article by Susan Dorman (John Hopkins). This article takes a good look at New Diagnostic Tests for Tuberculosis.

What’s new in TB diagnostics? A lot, but not enough. The future is brighter as several promising new tools enter the demonstration and late evaluation stages. But the need is great, and important barriers remain in translating technical advances into meaningful and sustainable improvements in individual and public health in settings hardest hit by TB.

So the challenge, to accept change, is now set before public and private health providers and policy makers.

Ms Dorman identifies one of those barriers, that of ignorance

lack of knowledge about the types of tests that are most needed and likely to be relevant

Withholding or delaying knowledge is one barrier to which public health officials can make a positive contribution - the inherent slowness of bureaucracy should no longer be a valid reason for delay.

And what of QuantiFERON?

To date, in the United States, use of these tests as replacements for or adjuncts to the tuberculin skin test has not been widespread, but momentum appears to be growing.

This is something that we have been seeing more of lately, changes to existing testing policies incorporating or favouring QuantiFERON.

current strategy in dialysis patients should use these tests (IGRA) instead of TST for LTBI screening and as an aid for the diagnosis of active TB.