Plenary Session 6

Abstract :
New diagnostic methods are the key to the better detection and control of tuberculosis. The diagnosis will cover the latent infection, incipient active, and bacteriologically detectable developed tuberculosis diseases. The bacteriological diagnostics will be adopted for the active case finding. In this context, we already have several new molecular diagnostic technologies, however, many of them are not real point-of-care testing (POCT). In addition, the clinical specimens are often sub-optimal especially in sputum vulnerable people like paediatrics, women and PLHIV. Then, it will be necessary to improve specimen collection technology and to develop real POCT with a capacity of detecting primary drug resistances.

One potential item for the improvement of sputum collection is Lung Flute ECO (LF ECO, Acoustic Innovations, Japan). It is a kind of musical instrument which sound waves induce vibrations in the lung cavity, reducing mucus viscosity and loosen mucus from the walls of the lung. A randomised cross-sectional study in Cameroon showed positive results; An additional 6.5% of participants were able to produce sputum with volume >1mL after use of the LF ECO as compared to after video instruction alone (OR 2.6 (1.9-3.7)), Of the 189 people who did not produce >1mL sputum following video instruction alone, 62% of these (117/189) produced >1mL sputum after use of the LF ECO. LF ECO will potentially increase the sensitivity of all types of TB bacteriological examinations.
Though it is not a POCT, targeted next generation sequencing (tNGS) will be a strong tool to diagnose any drug resistant TB within a few days. One of commercially available tNGSs, Deeplex Myc-TB (Genoscreen, France), has a capacity of detecting 15 drug resistances at one time. For the appropriate treatment of any drug-resistant TB, such comprehensive technology should be ulitised widely.