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dc.contributor.authorEngland, K
dc.contributor.authorMasini, T
dc.contributor.authorRajardo, E
dc.date.accessioned2019-11-20T01:53:34Z
dc.date.available2019-11-20T01:53:34Z
dc.date.issued2019-09-21
dc.date.submitted2019-11-13
dc.identifier.urihttp://hdl.handle.net/10144/619519
dc.description.abstractThe World Health Organization (WHO) currently recommends Xpert® MTB/RIF as the initial test for all people with presumptive tuberculosis (TB). A number of challenges have been reported, however, in using this technology, particularly in low-resource settings. Here we examine these challenges, and provide our perspective of the barriers to Xpert scale-up as assessed through a survey in 16 TB burden countries in which the Médecins Sans Frontières is present. We observed that the key barriers to scale-up include a lack of policy adoption and implementation of WHO recommendations for the use of Xpert, resulting from high costs, poor sensitisation of clinical staff and a high turnover of trained laboratory staff; insufficient service and maintenance provision provided by the manufacturer; and inadequate resources for sustainability and expansion. Funding is a critical issue as countries begin to transition out of support from the Global Fund. While it is clear that there is still an urgent need for research into and development of a rapid, affordable point-of-care test for TB that is truly adapted for use in low-resource settings, countries in the meantime need to develop functional and sustainable Xpert networks in order to close the existing diagnostic gap.en_US
dc.language.isoenen_US
dc.publisherInternational Union Against Tuberculosis and Lung Diseaseen_US
dc.rightsWith thanks to the International Union Against Tuberculosis and Lung Disease.en_US
dc.titleDetecting tuberculosis: rapid tools but slow progressen_US
dc.identifier.journalPublic Health Actionen_US
refterms.dateFOA2019-11-20T01:53:34Z


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