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BMC Proceedings

Open Access

Assessing new strategies for TB diagnosis in low- and middle-income countries

  • Afranio Lineu Kritski1,
  • Gisele Huf2,
  • Martha Maria Oliveira3,
  • S Bertie Squire4 and
  • Antonio Ruffino-Netto5
BMC Proceedings20148(Suppl 4):O12

https://doi.org/10.1186/1753-6561-8-S4-O12

Published: 1 October 2014

We will report the current situation of tuberculosis globally and in Brazil, the need for new strategies towards tuberculosis control, focusing on new diagnostic technologies. Critical comments are given on the state of the art regarding the evaluation of new health technologies, degree of scientific evidence needed, evaluation of clinical impact, cost-effectiveness of incorporation into the health system and the social impact.

Currently, the given pragmatic approach indicates that it is not appropriate to conduct an investigation on the incorporation of new technologies only in a "purely experimental" manner in clinical research centers. Research and practice clinical processes become intertwined and the main outcomes to be considered are the patient's health and actions creating a more effective health system in which the new technology will be incorporated. In this new scenario, it is essential that the academic biomedical areas reformulate their undergraduate curricula to include courses that address the development of new technologies, including the assessment of clinical impact, and economic and social incorporation of these new technologies into the current health system that will influence the future practice of their graduate students. In parallel, only through collaborative activities between academics, health service providers (public or private), producers of raw materials, laboratories and representatives of civil society will it be possible to conduct such studies under routine conditions in demonstration areas to enable an analysis appropriate to the relevance of the incorporation of new technologies in the country.

Authors’ Affiliations

(1)
Federal University of Rio de Janeiro
(2)
ENSP-Fiocruz
(3)
Rede TB
(4)
Liverpool School Public of Health
(5)
Faculdade de Medicina USP- Ribeirao Preto

References

  1. World Health Organization: Global Tuberculosis Control: surveillance, planning, financing. 2010, Geneva: World Health OrganizationGoogle Scholar
  2. Stop TB Partnership and World Health Organization. Global Plan to Stop TB 2006-2015. 2006, Geneva, World Health Organization, (WHO/HTM/STB/2006.35), [http://www.stoptb.org/assets/documents/global/plan/GlobalPlanFinal.pdf]
  3. Marais BJ, Raviglione M, Donald PR, Harries AD, Kritski AL, Graham SM, El-Sadr W, Harrington M, Mwaba P0, Churchyard G, Kauffman SHE, Whitty CJM, Atun R, Zumla A: Scale-up of services and research priorities for TB diagnosis, management and control: Call to action. Lancet. 2010, 375 (9732): 2179-2191. 10.1016/S0140-6736(10)60554-5.View ArticlePubMedGoogle Scholar
  4. Huf G, Kritski A: Evaluation of the clinical utility of new diagnostic tests for tuberculosis: the role of pragmatic clinical trials. J Bras Pneumol. 2012, 38 (2): 237-245. 10.1590/S1806-37132012000200014.View ArticlePubMedGoogle Scholar
  5. Thorpe KE, Zwarenstein M, Oxman AD, Treweek S, Furberg CD, Altman DG, Tunis S, Bergel E, Harvey I, Magid DJ, Chalkidou K: A pragmatic-explanatory continuum indicator summary (PRECIS): a tool to help trial designers. J Clin Epidemiol. 2009, 62 (5): 464-75. 10.1016/j.jclinepi.2008.12.011.View ArticlePubMedGoogle Scholar
  6. Wei X, Walley JD, Liang X, Liu F, Zhang X, Li R: Adapting a generic tuberculosis control operational guideline and scaling it up in China: a qualitative case study. BMC Public Health. 2008, 8: 260-10.1186/1471-2458-8-260.PubMed CentralView ArticlePubMedGoogle Scholar
  7. Mann G, Squire SB, Bissell K, Eliseev P, Du Toit E, Hesseling A, Nicol M, Detjen A, Kritski A: Beyond accuracy: creating a comprehensive evidence base for tuberculosis diagnostic tools. Int J Tuberc Lung Dis. 2010, 14 (12): 1518-1524.PubMedGoogle Scholar

Copyright

© Kritski et al.; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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