Diagnostic algorithms for tuberculosis in Europe: insights from the European Reference Laboratory Network for Tuberculosis (ERLTB-Net)
Saluzzo, Francesca Cabibbe, Andrea Maurizio Anthony, Richard Aubry, Alexandra Drobniewski, Francis Holicka, Yen Lillebaek, Troels Macedo, Rita Mansjö, Mikael Szél, Viktoria
Saluzzo, Francesca
Cabibbe, Andrea Maurizio
Anthony, Richard
Aubry, Alexandra
Drobniewski, Francis
Holicka, Yen
Lillebaek, Troels
Macedo, Rita
Mansjö, Mikael
Szél, Viktoria
Series / Report no.
Open Access
Type
Journal Article
Review
Article
Review
Article
Language
en
Date of publication
2025-11-15
Year of publication
Research Projects
Organizational Units
Journal Issue
Title
Diagnostic algorithms for tuberculosis in Europe: insights from the European Reference Laboratory Network for Tuberculosis (ERLTB-Net)
Translated Title
Published in
Lancet Reg Health Eur 2025; 60:101516
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.