Diagnosis

At the turn of the century, it was widely recognized that an accurate point-of care test for TB was required to make significant reductions in the pandemic. At this time, many novel tests had been developed by research groups or small biotech companies, but had never been standardized or evaluated for scale-up and application in low-resource, high-burden settings where the need is greatest. This motivated a major drive to systematically evaluate existing tests such as commercial liquid culture and nucleic acid amplification tests (NAAT), and to develop new approaches, principally led by the Foundation for Innovative New Diagnostics (FIND www.finddiagnostics.org) in collaboration with industry, government and clinical partners. The evidence generated by this renewed focus on novel TB diagnostic tests, processes and algorithms has led to a substantial number of policy revisions and new WHO recommendations (Table 4.1, see also www.tbevidence.org).