Time for a diagnostic sea-change: Rethinking neglected tropical disease diagnostics to achieve elimination

Citations Over TimeTop 10% of 2020 papers

Abstract

Never before has the importance of good diagnostic tests received such global attention. With the Coronavirus Disease 2019 (COVID-19) pandemic, sensitivity and specificity have become household terms. For neglected tropical diseases (NTDs), the need for good diagnostics is nothing new, but has grown increasingly acute in recent years. While today’s diagnostic tools have been sufficient for endemicity mapping and monitoring the progress of mass drug administration (MDA), they are largely insufficient for making stop treatment and surveillance decisions. A diagnostic sea change is required to develop new tests capable of taking NTD programs to the finish line of elimination. This starts with recognition that the testing needs for NTDs are unique. Unlike malaria, tuberculosis, or HIV, the preventative chemotherapy (PC)–treated NTDs are largely asymptomatic, and consequently, tests are rarely used to make individual diagnoses. Instead, NTD programs rely on tests to make good public health decisions. These decisions are made by applying diagnostic tests in conjunction with World Health Organization (WHO)–approved monitoring and evaluation (M&E) tools, which typically take the form of population-based surveys. Accurate program decisions can only be made with tests that are fit for purpose. Deploying such tests will require the NTD community to make 4 important changes in the way diagnostic tests are developed and applied.

Related Papers

• → The Global Burden of Disease Study 2010: Interpretation and Implications for the Neglected Tropical Diseases(2014)1,106 cited
• → What constitutes a neglected tropical disease?(2020)171 cited
• Old targets and new beginnings: a multifaceted approach to combating Leishmaniasis, a neglected tropical disease(2007)
• → Major Aboriginal populations and their neglected tropical diseases (NTDs).(2015)
• → Neglected Tropical Diseases, Phytochemicals, Protein Targets, and Mechanisms in Drug Discovery(2021)