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Glob Public Health. 2019 Aug 17:1-14. doi: 10.1080/17441692.2019.1650950. [Epub ahead of print]

The technological imperative in tuberculosis care and prevention in Vietnam.

Mason PH1,2,3,4, Lyttleton C2, Marks GB1,4,5, Fox GJ1,6.

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NHMRC Tuberculosis Centre of Research Excellence , Australia.
Department of Anthropology, Macquarie University , Sydney , Australia.
School of Social Sciences, Monash University , Clayton , Australia.
Woolcock Institute of Medical Research, University of Sydney , Glebe , Australia.
University of New South Wales , Sydney , Australia.
Central Clinical School, Faculty of Medicine and Health, The University of Sydney , Sydney , Australia.


A monocausal bacteriological understanding of infectious disease orients tuberculosis control efforts towards antimicrobial interventions. A bias towards technological solutions can leave multistranded public health and social interventions largely neglected. In the context of globalising biomedical approaches to infectious disease control, this ethnography-inspired review article reflects upon the implementation of rapid diagnostic technology in low- and middle-income countries. Fieldwork observations in Vietnam provided a stimulus for a critical review of the global rollout of tuberculosis diagnostic technology. To address local needs in tuberculosis control, health managers in resource-poor settings are readily cooperating with international donors to deploy novel diagnostic technologies throughout national tuberculosis programme facilities. Increasing investment in new diagnostic technologies is predicated on the supposition that these interventions will ameliorate disease outcomes. However, suboptimal treatment control persists even when accurate diagnostic technologies are available, suggesting that promotion of singular technological solutions can distract from addressing systemic change, without which disease susceptibility, propagation of infection, detection gaps, diagnostic delays, and treatment shortfalls persist.


GeneXpert; Vietnam; technology; tuberculosis

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