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dc.contributor.authorSabiiti, Wilber
dc.contributor.authorMtafya, Bariki
dc.contributor.authorKuchaka, Davis
dc.contributor.authorAzam, Khalide
dc.contributor.authorViegas, Sofia
dc.contributor.authorMdolo, Aaron
dc.contributor.authorFarmer, Eoghan
dc.contributor.authorKhonga, Margaret
dc.contributor.authorEvangelopoulos, Dimitrios
dc.contributor.authorHoneyborne, Isobella
dc.contributor.authorRachow, Andrea
dc.contributor.authorHeinrich, Norbert
dc.contributor.authorNtinginya, Nyanda Elias
dc.contributor.authorBhatt, Nilesh
dc.contributor.authorDavies, Gerry R
dc.contributor.authorJani, Ilesh V
dc.contributor.authorMcHugh, Timothy D
dc.contributor.authorKibiki, Gibson
dc.contributor.authorHoelscher, Michael
dc.contributor.authorGillespie, Stephen Henry
dc.contributor.authorPANBIOME (Pan-African Biomarker Expansion Programme) consortium
dc.identifier.citationSabiiti , W , Mtafya , B , Kuchaka , D , Azam , K , Viegas , S , Mdolo , A , Farmer , E , Khonga , M , Evangelopoulos , D , Honeyborne , I , Rachow , A , Heinrich , N , Ntinginya , N E , Bhatt , N , Davies , G R , Jani , I V , McHugh , T D , Kibiki , G , Hoelscher , M , Gillespie , S H & PANBIOME (Pan-African Biomarker Expansion Programme) consortium 2016 , ' Optimising molecular diagnostic capacity for effective control of tuberculosis in high-burden settings ' , International Journal of Tuberculosis and Lung Disease , vol. 20 , no. 8 , pp. 1004-1009 .
dc.identifier.otherORCID: /0000-0001-6537-7712/work/39477809
dc.identifier.otherORCID: /0000-0002-4742-2791/work/60196331
dc.description.abstractThe World Health Organization's 2035 vision is to reduce tuberculosis (TB) associated mortality by 95%. While low-burden, well-equipped industrialised economies can expect to see this goal achieved, it is challenging in the low- and middle-income countries that bear the highest burden of TB. Inadequate diagnosis leads to inappropriate treatment and poor clinical outcomes. The roll-out of the Xpert® MTB/RIF assay has demonstrated that molecular diagnostics can produce rapid diagnosis and treatment initiation. Strong molecular services are still limited to regional or national centres. The delay in implementation is due partly to resources, and partly to the suggestion that such techniques are too challenging for widespread implementation. We have successfully implemented a molecular tool for rapid monitoring of patient treatment response to anti-tuberculosis treatment in three high TB burden countries in Africa. We discuss here the challenges facing TB diagnosis and treatment monitoring, and draw from our experience in establishing molecular treatment monitoring platforms to provide practical insights into successful optimisation of molecular diagnostic capacity in resource-constrained, high TB burden settings. We recommend a holistic health system-wide approach for molecular diagnostic capacity development, addressing human resource training, institutional capacity development, streamlined procurement systems, and engagement with the public, policy makers and implementers of TB control programmes.
dc.relation.ispartofInternational Journal of Tuberculosis and Lung Diseaseen
dc.subjectHealth systemsen
dc.subjectDisease controlen
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.subjectSDG 3 - Good Health and Well-beingen
dc.titleOptimising molecular diagnostic capacity for effective control of tuberculosis in high-burden settingsen
dc.typeJournal articleen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. Gillespie Groupen
dc.contributor.institutionUniversity of St Andrews. Global Health Implementation Groupen
dc.contributor.institutionUniversity of St Andrews. Biomedical Sciences Research Complexen
dc.contributor.institutionUniversity of St Andrews. Infection Groupen
dc.description.statusPeer revieweden

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