Biotechnological Advances in Tuberculosis Diagnosis: Global Developments and Their Applicability in Indonesia / Kemajuan Bioteknologi dalam Diagnosis Tuberkulosis: Perkembangan Global dan Penerapannya di Indonesia

Tuberculosis (TB) remains a major global health burden, and Indonesia is among the countries with the highest incidence and mortality rates. Early and accurate diagnosis is essential for effective TB control; however, conventional diagnostic methods such as sputum smear microscopy, culture, chest radiography, and the tuberculin skin test continue to face limitations in sensitivity, specificity, turnaround time, and operational feasibility. This narrative review synthesizes global biotechnological developments in TB diagnostics and evaluates their potential applicability within the Indonesian healthcare system. A structured literature search was conducted using PubMed, ScienceDirect, and Google Scholar, applying Population, Intervention, Comparison, and Outcome (PICO) based inclusion and exclusion criteria. Key advances in molecular diagnostics include conventional polymerase chain reaction (PCR), real-time PCR, automated nucleic acid amplification test (NAAT) platforms such as GeneXpert, Xpert Ultra, and Truenat, as well as loop-mediated isothermal amplification (LAMP). Emerging innovations including CRISPR-based assays, biosensor platforms, microfluidic lab-on-chip devices, and nanotechnology-enhanced systems demonstrate improved sensitivity, portability, and testing speed, with potential for point-of-care implementation, although many require further field-based validation. No single diagnostic tool is universally optimal, as suitability depends on infrastructure availability, workforce capacity, and population needs. In Indonesia, persistent challenges include limited laboratory networks, high diagnostic costs, supply-chain constraints, and variability in human resource competence. Strengthening diagnostic systems, expanding decentralized testing, integrating digital health technologies, and supporting local production of diagnostic materials are critical to enable sustainable adoption and accelerate progress toward national TB elimination targets.

Tuberkulosis (TB) masih menjadi salah satu beban kesehatan global utama, dan Indonesia termasuk di antara negara dengan tingkat insidensi dan mortalitas tertinggi. Diagnosis yang dini dan akurat merupakan komponen kunci dalam pengendalian TB; namun, metode diagnostik konvensional seperti mikroskopi hapusan dahak, kultur, radiografi dada, dan uji tuberkulin masih memiliki keterbatasan dalam sensitivitas, spesifisitas, waktu penyelesaian pemeriksaan, serta kelayakan operasional. Tinjauan naratif ini bertujuan untuk merangkum perkembangan bioteknologi terkini dalam diagnosis TB secara global serta mengevaluasi potensi penerapannya dalam sistem pelayanan kesehatan di Indonesia. Pencarian literatur terstruktur dilakukan menggunakan basis data PubMed, ScienceDirect, dan Google Scholar dengan menerapkan kriteria inklusi dan eksklusi berbasis Population, Intervention, Comparison, and Outcome (PICO). Perkembangan penting dalam diagnostik molekuler meliputi polymerase chain reaction (PCR) konvensional, real-time PCR, platform nucleic acid amplification test (NAAT) otomatis seperti GeneXpert, Xpert Ultra, dan Truenat, serta teknik amplifikasi isotermal loop-mediated isothermal amplification (LAMP). Selain itu, inovasi yang sedang berkembang, termasuk diagnostik berbasis CRISPR, biosensor, perangkat mikrofluida lab-on-chip, dan sistem berbasis nanoteknologi, menunjukkan peningkatan sensitivitas, portabilitas, dan kecepatan pemeriksaan, dengan potensi penerapan sebagai diagnosis point-of-care, meskipun sebagian besar masih memerlukan validasi lapangan lebih lanjut. Tidak terdapat satu metode diagnostik yang bersifat universal, karena kesesuaiannya dipengaruhi oleh ketersediaan infrastruktur, kapasitas tenaga kesehatan, dan kebutuhan populasi. Di Indonesia, tantangan yang masih dihadapi mencakup keterbatasan jaringan laboratorium, tingginya biaya diagnostik, kendala rantai pasok, serta variasi kompetensi sumber daya manusia. Oleh karena itu, penguatan sistem diagnostik dan perluasan layanan pengujian terdesentralisasi menjadi langkah strategis untuk mendukung pencapaian target eliminasi TB nasional.