The impact of new tuberculosis diagnostics on transmission

Lin, H.H., Dowdy, D., Dye, C., Murray, M. and Cohen, T., 2012. The impact of new tuberculosis diagnostics on transmission: why context matters. Bulletin of the World Health Organization, 90, pp.739-747.

  • Faster Decline in Tuberculosis Burden: The use of a new diagnostic tool is expected to reduce the burden of pulmonary tuberculosis more rapidly compared to continued reliance on smear microscopy.
  • Influence of Contextual Factors: The impact of the new diagnostic tool on tuberculosis epidemiology is significantly influenced by contextual factors that are unrelated to the tool's performance.
  • Greatest Impact in Certain Settings: The epidemiological impact of the new tool is most significant in areas where access to tuberculosis care is good but where existing diagnostic strategies have low sensitivity, such as limited access to chest X-rays for smear-negative cases.
  • Lesser Impact in Equipped Laboratories: The new diagnostic tool may have a lesser impact at the population level if implemented in reference laboratories that are poorly accessible but already have sensitive diagnostic tools like culture.
  • Increased Patient Trust: A new diagnostic test could boost patients' confidence in the healthcare system and encourage physicians to consider tuberculosis diagnosis more readily, reducing delays for both patients and the health system.
  • Reduced Diagnostic Default: A new test with a quick turnaround time would lessen the need for multiple visits to the healthcare system, thereby decreasing the likelihood of patients defaulting on diagnosis.

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