Dados do Trabalho

Título

Assessing the Impact of GeneXpert MTB/RIF Implementation on Tuberculosis Diagnosis and Drug-Resistant Tuberculosis Control in Brazil: An Ecological Analysis

Introdução

Adequate laboratory diagnostic testing is crucial for effective management of tuberculosis (TB) and drug-resistant TB (DR-TB) cases. The implementation of GeneXpert MTB/RIF (GX-test) in 2014 aimed to enhance TB diagnosis, nonetheless its impact on testing rates and control of DR-TB across the country remains unexplored.

Objetivo (s)

This ecological study aims to evaluate the impact of GX-test implementation on rates of TB and DR-TB cases in Brazil.

Material e Métodos

We utilized 886.420 cases notified in the SINAN-TB database, between 2011 and 2021. Intervention time series (ITS) analysis was conducted to evaluate the impact of GX-test implementation on TB case notification rates. Forecast analysis was carried out to project the future trends of these tests using GX-test rates as regressors in ARIMAX modelling. Additionally, a regional analysis was conducted to explore the geographical distribution of testing and notification rates.

Resultados e Conclusão

ITS analysis demonstrated that the GX-test implementation had a significant impact on TB and DR-TB cases reported on SINAN-TB, while the forecast analysis indicated stable rates for the next 4 years, without significant increases or decreases. However, regional analysis unveiled substantial disparities, as the Southeast and South regions exhibited substantially higher rates compared to other regions.
Our study highlights the importance of GX-test implementation on the screening of TB and DR-TB in Brazil. The GX-test improves diagnostic rates by reducing logistical issues and laboratory workload, providing faster results with high sensitivity, as well as an easier implementation in limited resource settings. Additionally, it enables screening for rifampicin-resistant cases, further enhancing TB and DR-TB management. These findings underscore the importance of GX-test in earlier diagnosis and treatment initiation, emphasizing its value for public health measures.

Palavras-chave

Drug-Resistant Tuberculosis, GeneXpert MTB/RIF, laboratory diagnostics, forecast, public health measures

Agradecimentos

The authors thank Ms. Elze Leite (FIOCRUZ, Brazil) for logistics and administrative support, as well as the remainder of the team at MONSTER Research for their invaluable contribution to the study.