What services are there to diagnose TB?
Situation in 2013
Laboratory confirmation of TB and drug resistance is key to ensuring that individuals with TB signs and symptoms are correctly diagnosed and have access to the correct treatment as soon as possible. Of the 4.9 million incident (new and relapse) pulmonary TB patients notified globally in 2013, 2.8 million (58%) were bacteriologically confirmed, i.e., were smear- or culture-positive or positive according to a WHO-recommended rapid diagnostic such as Xpert® MTB/RIF. Xpert® MTB/RIF is being rapidly adopted by countries to detect TB and rifampicin-resistant TB. By the end of June 2014, 3269 testing machines and 7.5 million test cartridges had been procured by 108 of the 145 countries eligible for concessional prices.
Globally the target of having 1 sputum smear microscopy centre per 100 000 population has been met (1.1 centres per 100 000 population in 2013), but significant disparities remain at regional and country levels.
The current target for both culture and drug susceptibility testing (DST) capacity is one laboratory per 5 million population. In 2013, 12 of the 27 high MDR-TB burden countries did not reach the target, and several countries with large TB caseloads continue to completely lack in-country capacity for phenotypic DST.