Skip to content

Research at St Andrews

Optimising molecular diagnostic capacity for effective control of tuberculosis in high-burden settings

Research output: Research - peer-reviewArticle


Open Access permissions



Wilber Sabiiti, Bariki Mtafya, Davis Kuchaka, Khalide Azam, Sofia Viegas, Aaron Mdolo, Eoghan Farmer, Margaret Khonga, Dimitrios Evangelopoulos, Isobella Honeyborne, Andrea Rachow, Norbert Heinrich, Nyanda Elias Ntinginya, Nilesh Bhatt, Gerry R Davies, Ilesh V Jani, Timothy D McHugh, Gibson Kibiki, Michael Hoelscher, Stephen Henry Gillespie & 1 others

School/Research organisations


The World Health Organization's 2035 vision is to reduce tuberculosis (TB) associated mortality by 95%. While low-burden, well-equipped industrialised economies can expect to see this goal achieved, it is challenging in the low- and middle-income countries that bear the highest burden of TB. Inadequate diagnosis leads to inappropriate treatment and poor clinical outcomes. The roll-out of the Xpert® MTB/RIF assay has demonstrated that molecular diagnostics can produce rapid diagnosis and treatment initiation. Strong molecular services are still limited to regional or national centres. The delay in implementation is due partly to resources, and partly to the suggestion that such techniques are too challenging for widespread implementation. We have successfully implemented a molecular tool for rapid monitoring of patient treatment response to anti-tuberculosis treatment in three high TB burden countries in Africa. We discuss here the challenges facing TB diagnosis and treatment monitoring, and draw from our experience in establishing molecular treatment monitoring platforms to provide practical insights into successful optimisation of molecular diagnostic capacity in resource-constrained, high TB burden settings. We recommend a holistic health system-wide approach for molecular diagnostic capacity development, addressing human resource training, institutional capacity development, streamlined procurement systems, and engagement with the public, policy makers and implementers of TB control programmes.


Original languageEnglish
Pages (from-to)1004-1009
JournalInternational Journal of Tuberculosis and Lung Disease
Issue number8
StatePublished - 1 Aug 2016

    Research areas

  • Tuberculosis, Diagnostics, Health systems, Policy, Disease control

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. OMNIgene.SPUTUM suppresses contaminants whilst maintaining Mycobacterium tuberculosis viability and obviates cold-chain transport

    Azam, K., Cadir, N., Madeira, C., Gillespie, S. H. & Sabiiti, W. 16 Feb 2018 In : ERJ Open Research. 4, 8 p., 00074-2017

    Research output: Research - peer-reviewArticle

  2. Mycobacterial load assay

    Gillespie, S. H., Sabiiti, W. & Oravcova, K. 2017 Diagnostic Bacteriology: Methods and Protocols. Bishop-Lilly, K. A. (ed.). New York, NY: Humana Press/Springer, p. 89-105 17 p. (Methods in Molecular Biology; vol. 1616)

    Research output: ResearchChapter

  3. The impact of repeated NALC/NaOH- decontamination on the performance of Xpert MTB/RIF assay

    Rachow, A., Saathoff, E., Mtafya, B., Mapamba, D., Mangu, C., Rojas-Ponce, G., Ntinginya, N. E., Boeree, M., Heinrich, N., Gillespie, S. H., Hoelscher, M. & on behalf of the PanACEA-Consortium 4 Apr 2018 In : Tuberculosis. In press

    Research output: Research - peer-reviewArticle

  4. A population pharmacokinetic model incorporating saturable pharmacokinetics and autoinduction for high rifampicin doses

    Svensson, R. J., Aarnoutse, R. E., Diacon, A. H., Dawson, R., Gillespie, S. H., Boeree, M. J. & Simonsson, U. S. H. Apr 2018 In : Clinical Pharmacology & Therapeutics. 103, p. 674-683 10 p.

    Research output: Research - peer-reviewArticle

Related by journal

  1. Equitable tuberculosis care in the North West of England: analysis of tuberculosis cohort review data

    MacPherson, P., Squire, S. B., Cleary , P., Davies, S., Wake, C., Dee, K., Walker, J., Farrow, S., McMaster, P., Woodhead, M., Sloan, D. J. & on behalf of the North West TB Audit Steering Committee 1 Jun 2016 In : International Journal of Tuberculosis and Lung Disease. 20, 6, p. 778-785 8 p.

    Research output: Research - peer-reviewArticle

  2. Tuberculosis in the time of Ebola: Obstacles and opportunities

    Sloan, D. J. & O'Dempsey, T. J. 1 Nov 2015 In : International Journal of Tuberculosis and Lung Disease. 19, 11, p. 1269 1 p.

    Research output: Research - peer-reviewEditorial

  3. Vitamin D deficiency in Malawian adults with pulmonary tuberculosis: risk factors and treatment outcomes

    Sloan, D. J., Mwandumba, H. C., Kamdolozi, M., Shani, D., Chisale, B., Dutton, J., Khoo, S. H., Allain, T. J. & Davies, G. R. 1 Aug 2015 In : International Journal of Tuberculosis and Lung Disease. 19, 8, p. 904-911 8 p.

    Research output: Research - peer-reviewArticle

  4. Managing malaria in tuberculosis patients on fluoroquinolone-containing regimens: assessing the risk of QT prolongation.

    Singh, K., laurenzi, M., Brown, M. & Gillespie, S. H. Feb 2012 In : International Journal of Tuberculosis and Lung Disease. 16, 2, p. 144-149 6 p.

    Research output: Research - peer-reviewReview article

Related by journal

  1. International Journal of Tuberculosis and Lung Disease (Journal)

    Gillespie, S. H. (Editor)

    Activity: Publication peer-review and editorial workEditor of research journal

ID: 241651392