The technological imperative in tuberculosis care and prevention in Vietnam

ABSTRACT

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.

KEYWORDS:

• Vietnam
• tuberculosis
• technology
• GeneXpert

Acknowledgements

Ethics approval was granted by the University of Sydney Human Research Ethics Committee on 8 January 2014. Project No: 2013/814.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Paul H. Mason http://orcid.org/0000-0002-5488-1056

Additional information

Funding

This research was funded by a seeding grant from the NHMRC Centre of Research Excellence in Tuberculosis Control, the Ann Woolcock Early Career Researcher Travel Fellowship from the Woolcock Institute of Medical Research. GJF was supported by a NHMRC CJ Martin Early Career Fellowship [grant number APP1054107].