Abstract: Despite advances in centralized molecular diagnostics, such as GeneXpert, nearly 30-40% of global TB cases remain undiagnosed because of logistical barriers at the periphery, such as lack of power, cold chains, and skilled staff at primary health centres (PHCs). This study evaluated two near-point-of-care (nPOC) platforms, Uniamp (Huwel Diagnostics)/ Pluslife MiniDock and TruePOC MTB Ultima (Molbio), for integration into the National TB Programmes (NTPs). Utilizing insights from field trials conducted in Southeast Asia, and Sub-Saharan Africa, along with WHO benchmarks for 2024–2025, we summarised evidence on technical performance, operational resilience, and economic factors. TruePOC offers micro-PCR on disposable chips with the ability to detect Rif/Isoniazid resistance, whereas Pluslife employs isothermal RHAM amplification for quicker, energy-efficient results. Both systems achieve 91–93% sensitivity in sputum samples compared to GeneXpert Ultra, with Pluslife allowing (85.7% sensitivity) and TruePOC (77.9% sensitivity) for tongue swabs in patients who are difficult to sample, such as children. The average cost per sample is $3.6, which is way more economical than centralized testing costs of $18–25 (including transportation). Challenges include digital integration and scaling up training; however, with adaptations by NTP, such as linking to the Nikshay portal and implementing quality assurance (QA), these tools support the goal of decentralized TB elimination by 2030.
Bridging the Last Mile: How Near-Point-of-Care Diagnostics Are Rewriting the Rules for TB Elimination
