Modelling study MDR-TB test development

Resistance to tuberculosis (TB) drugs is a major public health problem threatening progress made in TB control worldwide. In some European and Central Asian countries, over 15 % of new and 50 % of previously treated TB cases have multidrug-resistant tuberculosis (MDR-TB) that cannot be treated with cheap first-line drugs. Extensively-resistant TB (XDR-TB) requires toxic and expensive treatment for 1.5-2 years.

Results of conventional culture tests take weeks to months. Meanwhile patients often receive improper antibiotic regimens and can transmit resistant TB to other patients. Reliable rapid diagnostic tests to differentiate between MDR-TB and XDR-TB are needed.

AIGHD epidemiologist Anja van’t Hoog constructed a decision analytical model simulating TB patients in the Republic of Georgia to look at the impact of faster diagnostic methods. The study predicted that a rapid high-throughput molecular assay for early detection of first- and second-line tuberculosis drug resistance could potentially reduce combined costs for diagnosis, treatment, and hospitalization by 17-21%. However, due to misclassification, the period during which XDR-patients may infect other TB patients could increase by ±15 %. The study concluded that further development of rapid second-line resistance testing should prioritize investment in optimizing molecular markers above investments in a platform for direct analysis of sputum.

Read publication modeling study here

Read other publication on assay that the project was about here