Revitalizing decentralized tuberculosis diagnosis in primary laboratories: post-COVID-19 challenges and strategic innovations
Year: 2025
Type: article
Abstract: Tuberculosis (TB) remains a global public health challenge, particularly in resource-limited settings, where centralized diagnostic systems may be constrained by logistical delays, infrastructure gaps, and limited workforce capacity. In recent years, decentralized diagnostic approaches have emerged as promising alternatives to improve access, timeliness, and patient-centered care. This narrative review examines the evolving landscape of decentralized TB diagnostics in primary laboratories, especially in the post-COVID-19 era, where pandemic-related investments in health infrastructure and digital systems have created new opportunities for diagnostic reform. We identify and synthesize five persistent implementation challenges — quality assurance, human resource limitations, infrastructural deficits, financial sustainability, and community engagement — as well as several key enablers, including portable molecular technologies, digital health platforms, and policy-linked diagnostic networks. This review highlights the importance of embedding decentralized models into national TB programs, supported by regulatory frameworks, sustainable financing, and cross-sector collaboration. Accelerating the institutionalization of decentralized diagnostics is essential to achieving diagnostic equity and advancing TB elimination goals in high-burden countries.
Authors: Xiaodong Liu, Qingjun Jia, Cai Hu
Institution: Hangzhou Center for Disease Control and Prevention
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414364120