By Gift Briton

Over the last three decades, Tuberculosis (TB) diagnostic tests have evolved, the latest being genome sequencing. However, delayed detection remains a major impediment to eradicating this disease.

In Kenya, for instance, almost half of TB cases are not diagnosed on time. According to TB Professor, Jeremiah Chakaya from the Light Consortium, late diagnosis fuels new transmission of the disease among the population, giving the infection a chance to develop in a person.

“There is a big need to come up with tests that people can use on their own and in their rooms like in the case of HIV self-test kits. TB needs to go in that direction to come up with a point-of-care test because all the molecular tests available today still require a laboratory infrastructure and they are really expensive,” Prof. Chakaya told ScienceAfrica during a recent TB symposium in Kenya organized by the Light Consortium in collaboration with the Ministry of Health.

“Right now in Kenya, even though we have a lot of primary healthcare centres, many of those centres do not have the capacity to diagnose TB. Most people with TB symptoms who visit dispensaries are either asked to submit a specimen that is then pooled with other specimens and taken to a diagnostic centre or they may be referred to a facility that diagnoses TB.”

He observes that both options are not optimal, adding that if every single facility would be equipped to identify TB cases early, as soon as the patient walks in to seek treatment, it would be a big advancement.

The fastest way to lower TB burden, according to Prof. Chakaya, is to find everyone with TB very early and put them on treatment immediately. However, he observes that this approach might not be possible, especially in low-resource settings.

“The better way to reduce TB burden is to improve the socioeconomic status of the people and combine it with a good TB program. The bare minimum is to make sure that when people are sick and they visit a health facility, and if they have TB, the disease is picked up as quickly as possible,” he opined.

Prof. Chakaya further urges governments to provide quality education, social protection schemes, and improve the socioeconomic conditions of the population, adding that “We must move people out of poverty. We cannot continue having a growing number of poor people and expect that TB will take a walk.”

Achieving universal health coverage, he noted, will enable people to access quality health services in the nearest possible place. Thus, a combination of improved welfare status and good health services will reduce the TB burden.