I heard on NPR this morning that the WHO (Keith Moon died 32 years ago) is supporting the new rapid TB test made by Cepheid (MTB/RIF test). You can read more about the test characteristics in the recent NEJM article. They reported 98% sensitivity in smear-positive patients but only 73% sensitivity in smear-negative patients after a single test. Sensitivity rises to 85% after a second test and to 90% after a third test. The test was very good at identifying rifampin-resistant and rifampin-sensitive strains (both around 98% of the time).
The NPR article states that the processor costs $64,000 in US but could be $17,000 for developing countries. Tests will cost $17. If you need to do three tests in smear-negative patients to rule out TB with a sensitivity of 90%, it would cost $51. I wonder if developing country budgets can absorb that cost?
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