Extract
To the Editor:
Accurate and rapid diagnosis is crucial for tuberculosis control by ensuring a timely start to treatment and reducing transmission. In 2012, almost one third of tuberculosis cases were not diagnosed and/or reported to national tuberculosis programmes (NTPs), and <25% of estimated incident multidrug-resistant (MDR) cases were diagnosed [1]. Xpert MTB/RIF (Cepheid, Sunnyvale, CA, USA), a nucleic acid amplification test, was recommended in 2010 by the World Health Organization (WHO) for detection of HIV-associated pulmonary tuberculosis and rifampicin resistance [2]. In 2013, the test was recommended for detection of paediatric tuberculosis and some forms of extrapulmonary tuberculosis (EPTB), as well as an initial test to replace smear microscopy [3].
Following these recommendations, modules and cartridges have been procured in increasing numbers. As of June 30, 2014, 15 846 Xpert modules and 7.5 million cartridges were procured by 104 countries at concessional prices [4], yet the potential market is much larger [5]. Although general policies regarding Xpert in the 22 high-burden countries (HBCs) have been summarised [1] and some experiences from early Xpert implementers are available [6,7], a more comprehensive analysis of NTPs’ policies and implementation of Xpert has not been performed.
To assess the current landscape of implementation of Xpert, we designed a
- Received August 12, 2014.
- Accepted October 6, 2014.
- ©ERS
