Tuberculosis Diagnostics and Biomarkers: Needs, Challenges, Recent Advances, and Opportunities
Open accessAbstract
Tuberculosis is unique among the major infectious diseases in that it lacks accurate rapid point-of-care diagnostic tests. Failure to control the spread of tuberculosis is largely due to our inability to detect and treat all infectious cases of pulmonary tuberculosis in a timely fashion, allowing continued Mycobacterium tuberculosis transmission within communities. Currently recommended gold-standard diagnostic tests for tuberculosis are laboratory based, and multiple investigations may be necessary over a period of weeks or months before a diagnosis is made. Several new diagnostic tests have recently become available for detecting active tuberculosis disease, screening for latent M. tuberculosis infection, and identifying drug-resistant strains of M. tuberculosis. However, progress toward a robust point-of-care test has been limited, and novel biomarker discovery remains challenging. In the absence of effective prevention strategies, high rates of early case detection and subsequent cure are required for global tuberculosis control. Early case detection is dependent on test accuracy, accessibility, cost, and complexity, but also depends on the political will and funder investment to deliver optimal, sustainable care to those worst affected by the tuberculosis and human immunodeficiency virus epidemics. This review highlights unanswered questions, challenges, recent advances, unresolved operational and technical issues, needs, and opportunities related to tuberculosis diagnostics.
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Availability issues, such as geographical constraints, resource shortages, or long waiting times, can cause significant diagnostic errors even when specific tests exist.
“Second, availability issues, such as geographical constraints, resource shortages, or long waiting times, can cause significant diagnostic errors even when specific tests exist [189,190].”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [189]
In “The Need for More Accurate and Rapid Diagnostics” (page not provided), the paper says that tests can be beyond patients’ reach and that limited facilities and diagnostic delays leave tuberculosis cases undetected. “Dilemmas and Priorities for the Future” also describes access problems when services are centralized. These passages support the availability concern, but do not specifically establish that it causes significant diagnostic errors, as opposed to delays or missed diagnoses. (LLM, conf=0.84)
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Jeremiah, K., Lyimo, E., Ritz, C., PrayGod, G., Rutkowski, K. T., Korsholm, K. S., Rühwald, M., Tait, D. R., Grewal, H. M. S., & Faurholt‐Jepsen, D. (2021) · PLoS ONE · doi:10.1371/journal.pone.0252808 · Cited by 11 · see citing works
MiR-27a-3p and miR-30b-5p inhibited-vitamin D receptor involved in the progression of tuberculosis
Xiao, M., Yang, S., Zhou, A., Li, T., Liu, J., Chen, Y., Luo, Y., Qian, C., Yang, F., Tang, B., et al. (2022) · Frontiers in Microbiology · doi:10.3389/fmicb.2022.1020542 · Cited by 11 · see citing works
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- Authors
- McNerney, R., Maeurer, M., Abubakar, I., Marais, B., Mchugh, T. D., Ford, N., Weyer, K., Lawn, S., Grobusch, M. P., Memish, Z., Squire, S. B., Pantaleo, G., Chakaya, J., Casenghi, M., Migliori, G.-B., Mwaba, P., Zijenah, L., Hoelscher, M., Cox, H., Swaminathan, S., Kim, P. S., Schito, M., Harari, A., Bates, M., Schwank, S., O’Grady, J., Pletschette, M., Ditui, L., Atun, R., & Zumla, A.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- Karolinska Institutet (SE)
- University of East Anglia (GB)
- The University of Sydney (AU)
- University College London (GB)
- Médecins Sans Frontières (ZA)
- World Health Organization (CH)
- University of Cape Town (ZA)
- Amsterdam UMC Location University of Amsterdam (NL)
- Alfaisal University (SA)
- Liverpool School of Tropical Medicine (GB)
- Centre Hospitalier Universitaire Vaudois (CH)
- Kenya Medical Research Institute (KE)
- Ministry of Health (ZM)
- University of Zimbabwe (ZW)
- National Institute of Research in Tuberculosis (IN)
- National Institutes of Health (US)
- Henry M. Jackson Foundation (US)
- University of Zambia (ZM)
- European Commission (BE)
- Global Fund to Fight AIDS, Tuberculosis and Malaria (CH)
- Corresponding author
- McNerney, Ruth
- ORCID
- McNerney, Ruth
- Maeurer, Markus
- Abubakar, Ibrahim
- Marais, Ben
- Mchugh, Timothy D.
- Ford, Nathan
- Grobusch, Martin P.
- Memish, Ziad
- Squire, S. Bertel
- Pantaleo, Giuseppe
- Chakaya, Jeremiah
- Casenghi, Martina
- Mwaba, Peter
- Zijenah, Lynn
- Cox, Helen
- Swaminathan, Soumya
- Kim, Peter S.
- Schito, Marco
- Harari, Alexandre
- Bates, Matthew
- O’Grady, Justin
- Atun, Rifat
- Zumla, Alimuddin
- Venue
- The Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-05-15
- Volume
- 205
- Issue
- suppl_2
- Pages
- S147-S158
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- OpenAlex
- W2145481449
- Cited by
- 191
- References
- 85
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 4 · 2023: 8 · 2022: 9 · 2021: 9 · 2020: 5 · 2019: 12 · 2018: 7 · 2017: 13 · 2016: 16 · 2015: 23 · 2014: 21 · 2013: 36 · 2012: 12
- FWCI
- 3.67
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- The Journal of Infectious Diseases (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- SERVAL (Université de Lausanne) (publishedVersion, other-oa)
- NIRT Institutional Scholarship Repository (National Institute of Research in Tuberculosis) (acceptedVersion)
- reroDoc Digital Library (submittedVersion)
- IRIS (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- LSTM Online Archive (Liverpool School of Tropical Medicine) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Medecins Sans Frontieres Field Research (Medecins Sans Frontieres) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Funders
- University College London
- UBS Optimus Foundation
- University College London Hospitals NHS Foundation Trust
- Medical Research Council
- European and Developing Countries Clinical Trials Partnership
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Surgery › Infectious Diseases and Tuberculosis
- Health Sciences › Medicine › Surgery › Diagnosis and treatment of tuberculosis
- Keywords
- tuberculosis diagnosis, Mycobacterium tuberculosis, biomarkers, point-of-care testing, latent tuberculosis infection, drug-resistant tuberculosis, early case detection, tuberculosis control
- MeSH terms
- Antitubercular Agents, Bacteriological Techniques, Humans, Tuberculosis, Biomarkers, Drug Resistance, Bacterial
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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