Abstract

Tracy Seaman, Andre Trollip, Richard Mole and Heidi Albert*

Sub-Saharan Africa has experienced a significant increase in tuberculosis cases in recent years, fuelled by high rates of TB- HIV co-infection in the region. The diagnosis of tuberculosis is based largely on clinical assessment, sputum smear microscopy and chest radiography. Although smear microscopy is useful for detecting the most infectious cases, a significant portion of cases are negative on sputum smears, making diagnosis more difficult. New tests are urgently needed. The FASTPlaqueTB test, a bacteriophage-based method, has been evaluated in several studies in Africa and elsewhere. Studies in South Africa and Pakistan reported that between half and two-thirds of smearnegative culture-positive TB cases were detected by the FASTPlaqueTB test within 2 days. This suggests a beneficial role for this test in the early diagnosis of clinically suspected smear-negative cases. The same technology has been applied to develop a rapid test to indicate multi-drug resistant TB, FASTPlaqueTB-MDRi. This test gave equivalent results to conventional drug susceptibility methods, but with more rapid results. The tests are simple to perform and require no specialised equipment, making the technology suitable for widespread implementation.