Poor quality of TB diagnosis is a major problem that needs to be addressed

By Danielle Cazabon | 06 Mar, 2017

Hi all,

This recently published review discusses the poor quality of TB care and the urgent need for improvement in this area.

We would love to hear feedback from the community regarding this topic.

Kind regards,


Attached resource:



Mark Fisher Replied at 3:22 PM, 6 Mar 2017

Thanks for the interesting and important article. The part I find most interesting is Figure 3 that looks at the cascade of care in India. These models help to better understand where the losses are, but what can we do to minimize those losses? When I look at this, I ask myself "what can we do to eliminate a step?", "what are the current barriers?" and "what are five interventions that may help?". One of the problems I see with coming to a good solution is that the problems are so multi-disciplinary and thus demand a multi-disciplinary solution.
As an example, the biggest loss is getting TB suspect people to the clinic according to the chart. Here are a few possibilities: need to work, can't easily get to clinic, distrust of clinics/modern medicine, lack of available testing locally, and simply too sick to travel. I'm sure I am missing another dozen. The solutions to this very first issue likely include elements anthropology/sociology, public health (inc. cost effectiveness), logistics, engineering, science and communications.
I think that the best first step in addressing the gaps is to first have an in-depth understanding of the user needs/barriers to a better TB diagnosis and treatment approach. With this information, a more informed systemic approach could be devised to identify and effectively treat people with TB.