Effectiveness and trend forecasting of tuberculosis diagnosis after the introduction of GeneXpert in a city in south-eastern Brazil

• Published in: PloS one Vol. 16; no. 5; p. e0252375
• Main Authors: Berra, Thaís Zamboni, Gomes, Dulce, Ramos, Antônio Carlos Vieira, Alves, Yan Mathias, Bruce, Alexandre Tadashi Inomata, Arroyo, Luiz Henrique, Santos, Felipe Lima dos, Souza, Ludmilla Leideanne Limirio, Crispim, Juliane de Almeida, Arcêncio, Ricardo Alexandre
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 28-05-2021; Public Library of Science (PLoS)
• Subjects: Biology and Life Sciences; Cerebrospinal fluid; Culture; Diagnosis; Disease; Evaluation; HIV; HIV infection; Human immunodeficiency virus; Human resources; Infections; Medical diagnosis; Medical tests; Medical treatment; Medicine and Health Sciences; Nursing; People and places; Performance evaluation; Physical Sciences; Public health; Tuberculosis; Brazil
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0252375

To evaluate the effectiveness of a rapid molecular test for the detection of tuberculosis (TB) and to predict the rates of disease in a municipality of Brazil where TB is endemic. An ecological study was carried out in Ribeirão Preto-SP on a population of TB cases notified between 2006 and 2017. Monthly TB incidence rates and the average monthly percentage change (AMPC) were calculated. In order to identify changes in the series, the breakpoint technique was performed; the rates were modelled and predictions of the incidence of TB until 2025 were made. AMPC showed a fall of 0.69% per month in TB and human immunodeficiency virus (TB-HIV) co-infection, a fall of 0.01% per month in general and lung TB and a fall of 0.33% per month in extrapulmonary TB. With the breakpoint technique, general and pulmonary TB changed in structure in late 2007, and extrapulmonary TB and TB-HIV co-infection changed in structure after 2014, which is considered the cut-off point. The IMA(3) models were adjusted for general and pulmonary TB and TB-HIV co-infection, and the AR(5) models for extrapulmonary TB, and predictions were performed. The rapid molecular test for TB is the method currently recommended by the WHO for the diagnosis of the disease and its main advantage is to provide faster, more accurate results and to already check for drug resistance. It is necessary that professionals encourage the use of this technology in order to optimize the diagnosis so that the treatment begins as quickly as possible and in an effective way. Only by uniting professionals from all areas with health policies aimed at early case identification and rapid treatment initiation it is possible to break the chain of TB transmission so that its rates decrease and the goals proposed by the WHO are achieved.