Diagnostic algorithms for tuberculosis in Europe: insights from the European Reference Laboratory Network for Tuberculosis (ERLTB-Net).
expert_opinion · Level V
Where this comes from
- Record sourced from PubMed, PMID 41323364.
- Also identified by DOI 10.1016/j.lanepe.2025.101516 and PMC identifier 12664343.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
The reported poor treatment outcomes for extensively drug-resistant tuberculosis (TB) in the European region highlight the urgent need for effective and context-appropriate diagnostic strategies. While the World Health Organisation (WHO) provides model algorithms, these require adaptation to the European Union/European Economic Area (EU/EEA) context, a setting with low TB incidence but high resources. This viewpoint from the European Reference Laboratory Network for TB (ERLTB-Net) proposes a tailored diagnostic algorithm that prioritises the universal use of WHO-recommended molecular rapid diagnostic tests, systematic culture, and whole genome sequencing (WGS). This approach integrates phenotypic drug susceptibility testing strategically and outlines the possible role of targeted next-generation sequencing (tNGS) in the EU/EEA setting. The algorithm also addresses the importance of diagnostic harmonisation, cross-border collaboration, and sustained investment in sequencing capacity. By aligning diagnostic practices with the regional epidemiology and laboratory infrastructure, this stepwise, resource-sensitive approach aims to strengthen TB control, improve treatment outcomes, and guide public health action in the EU/EEA.