Innovative Diagnostic Method for Tuberculosis Promises Enhanced Detection

A groundbreaking strategy for screening tuberculosis (TB), developed by researchers led by Queen Mary University of London, offers a promising solution to the limitations faced by current TB diagnostic methods. Traditional screening approaches often struggle with accurately identifying both active and dormant TB infections, which hampers efforts to control the disease’s spread. The new approach integrates testing for active disease alongside detecting latent TB infections simultaneously, potentially saving more lives, reducing transmission rates, and transforming public health strategies.

TB remains a significant global health concern, with over 10.8 million new cases and approximately 1.25 million deaths reported in 2023. One challenge is that TB can remain dormant in the body for years without symptoms, only to reactivate later, especially in individuals with weakened immune systems or those at high risk. Therefore, effective screening that accurately detects both active and latent TB is crucial for timely intervention.

Current testing methods include chest X-rays, sputum analysis, molecular diagnostics, symptom screening, and blood or skin tests for latent TB infection (TBI). However, these methods often have limitations regarding sensitivity and specificity, leading to false positives or missed cases. To improve this, Dr. Dominik Zenner and his team reviewed data from 437 studies involving 13 different TB tests, assessing their ability to correctly diagnose TB and minimize false positives.

Their research, published in the European Respiratory Journal, revealed that incorporating immunological tests aimed at identifying dormant TB infections enhances the overall effectiveness of screening algorithms. These TBI tests are particularly valuable in diagnosing extrapulmonary TB and TB in children, which are traditionally difficult to detect. Notably, the study challenges conventional protocols that reserve TBI testing for latent infections, suggesting that combined testing for both active and dormant TB could be more effective.

This novel approach has significant implications for health policy and disease management, especially in high-risk populations such as migrants from regions with high TB prevalence. As Dr. Zenner stated, simultaneous screening for active and latent TB in these groups can improve early detection and treatment outcomes.

Expert opinion from Mario Raviglione, former WHO TB program director, highlights that adopting tests like the Interferon Gamma Release Assay (IGRA), a blood-based test detecting immune response to TB antigens, alongside traditional diagnostics, could substantially advance screening accuracy. Such integrated strategies are especially vital in regions like East London, where TB disproportionately affects socioeconomically deprived communities. Ongoing collaborations, including the recent partnership with Barts Health NHS Trust, aim to establish centers of excellence for TB research and treatment.

This innovative diagnostic paradigm aligns with global efforts to enhance TB control, emphasizing early, precise detection across diverse populations. As research progresses, this approach could lead to widespread changes in screening guidelines, ultimately reducing TB incidence worldwide.